Active NPI
Lynette R Connelly, LCSW
- Clinical Social Worker
- Westminster, MD
National Provider Identifier
1740293505
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 06613
- Practice address
- 202 E Main St
Westminster, MD 21157-5355 - Phone
- (410) 848-7830
- Fax
- (410) 876-4791
- NPI assigned
- Aug 14, 2006
- Last updated
- Feb 24, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 06613 | MD | Primary |
Addresses
Primary practice location
202 E Main St
Westminster, MD 21157-5355
Mailing address
4623 Falls Rd
Baltimore, MD 21209-4914
Phone (410) 366-1980
Other identifiers 13
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 257613 | Other | MD | KAISER |
| 2321497000 | Other | MD | AMERIHEALTH |
| 231252 | Other | MD | COMPSYCH |
| 396957 | Other | MD | TRICARE |
| 248514 | Other | MD | UNITED BEHAVORIAL HEALTH |
| T541-0004 | Other | DC | CAREFIRST BCBS |
| 038119 | Other | MD | VALUE OPTIONS |
| 284441 | Other | MD | MAMSI |
| 7983549 | Other | MD | AETNA |
| PVPB213077 | Other | MD | APS HEALTHCARE |
| 530200500 | Medicaid | MD | |
| 298638-000 | Other | MD | MAGELLAN |
| 887526-01 | Other | MD | CAREFIRST BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101215001114 | MD | Practitioner - Clinical Social Worker | 7012105117 | Practice locations: Westminster, MD |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 1988
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
202 E Main St
Westminster, MD 21157-5355
Phone (410) 848-7830
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 06613 | MD | MD | Clinical Social Worker |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Westminster, MD
- NPI 1275349441
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155513600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1519430400000",
"number": "1740293505",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4623 FALLS RD",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212094914",
"telephone_number": "410-366-1980",
"fax_number": "410-366-8530"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "202 E MAIN ST",
"city": "WESTMINSTER",
"state": "MD",
"postal_code": "211575355",
"telephone_number": "410-848-7830",
"fax_number": "410-876-4791"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONNELLY",
"first_name": "LYNETTE",
"middle_name": "R",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-14",
"last_updated": "2018-02-24",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MD",
"license": "06613",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KAISER",
"identifier": "257613",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIHEALTH",
"identifier": "2321497000",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COMPSYCH",
"identifier": "231252",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "396957",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED BEHAVORIAL HEALTH",
"identifier": "248514",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAREFIRST BCBS",
"identifier": "T541-0004",
"state": "DC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUE OPTIONS",
"identifier": "038119",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAMSI",
"identifier": "284441",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "7983549",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "APS HEALTHCARE",
"identifier": "PVPB213077",
"state": "MD"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "530200500",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAGELLAN",
"identifier": "298638-000",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAREFIRST BCBS",
"identifier": "887526-01",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Westminster, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.