Amanda Joyce Jacob Pezzanite, LCSW-C

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

19151 Issued in MD

Practice address

4915 Saint Elmo Ave Ste 504
Bethesda, MD 20814-6019

Phone

(301) 299-0063

NPI assigned

Nov 5, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 10, 2023 through Jan 10, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• DBT Maryland LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bethesda, MD
  • NPI 1407517519
  NPD Authorized official

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

{
    "created_epoch": "1572912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572912000000",
    "number": "1760026413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4915 SAINT ELMO AVE STE 504",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208146019",
            "telephone_number": "301-299-0063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4915 SAINT ELMO AVE STE 504",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208146019",
            "telephone_number": "301-299-0063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEZZANITE",
        "first_name": "AMANDA",
        "middle_name": "JOYCE JACOB",
        "name_prefix": "Mrs.",
        "credential": "LCSW-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-05",
        "last_updated": "2019-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "19151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carol Guzewicz Petrie, P.T.
• Wehazit Petros
• Lindsay Petty, RN, BSN, IBCLC
• Jennifer C. Petzel, LCSW-C
• Maria Gabriela Pezo
• Maddison L Pezzelle, MSSW, LMSW
• Susan Pfeiffer, PA-C
• Duyen Ky Pham Hua
• Anh Tuan Pham
• Hongvan Thi Pham, PHARM D.

• Clinical Social Worker in Bethesda, MD
• Providers in Bethesda, MD by specialty
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2019; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.