Individual provider Active NPI

Nicole Munoz, LCSWC CCDC LLC

  • Social Worker
  • Towson, MD
National Provider Identifier
1740329010
Registry record updated Sep 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
11819 Issued in MD
Practice address
744 Dulaney Valley Rd
Suite 2
Towson, MD 21204-5132
Phone
(410) 494-6668
Fax
(443) 403-2566
NPI assigned
Feb 5, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 11819 MD Primary

Addresses

Primary practice location

744 Dulaney Valley Rd
Suite 2
Towson, MD 21204-5132

Mailing address

744 Dulaney Valley Rd
Suite 2
Towson, MD 21204-5132
Phone (410) 494-6668

Other identifiers 1

IdentifierTypeStateIssuer
401199600MedicaidMD

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190620000777 MD Practitioner - Clinical Social Worker 2668653718 Practice locations: Towson, MD

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

521 E Joppa Rd
Suite 204a
Towson, MD 21286-1807
Phone (410) 494-6668

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11819MDMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Bay Life Services Corporation Past Accepting new patients
Nicole Munoz, LCSW-C, LLC PastSince Feb 25, 2019 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285286400000",
    "number": "1740329010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "744 DULANEY VALLEY RD",
            "address_2": "SUITE 2",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212045132",
            "telephone_number": "410-494-6668",
            "fax_number": "443-403-2566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "744 DULANEY VALLEY RD",
            "address_2": "SUITE 2",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212045132",
            "telephone_number": "410-494-6668",
            "fax_number": "443-403-2566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNOZ",
        "first_name": "NICOLE",
        "credential": "LCSWC CCDC LLC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-05",
        "last_updated": "2010-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MD",
            "license": "11819",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "401199600",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Towson, MD

Sources for this page

Verify at the official NPI Registry.