Active NPI
Maurice R Mimms, LMSW
- Social Worker
- District Heights, MD
National Provider Identifier
1760095640
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 25755
- Practice address
- 1206 Waterford Dr
District Heights, MD 20747-1733 - Phone
- (301) 996-9942
- NPI assigned
- Aug 28, 2020
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 25755 | MD | Primary |
Addresses
Primary practice location
1206 Waterford Dr
District Heights, MD 20747-1733
Mailing address
1206 Waterford Dr
District Heights, MD 20747-1733
Phone (301) 996-9942
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25755 | MD | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1598572800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1598572800000",
"number": "1760095640",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1206 WATERFORD DR",
"city": "DISTRICT HEIGHTS",
"state": "MD",
"postal_code": "207471733",
"telephone_number": "301-996-9942"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1206 WATERFORD DR",
"city": "DISTRICT HEIGHTS",
"state": "MD",
"postal_code": "207471733",
"telephone_number": "301-996-9942"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIMMS",
"first_name": "MAURICE",
"middle_name": "R",
"name_prefix": "Mr.",
"credential": "LMSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-08-28",
"last_updated": "2020-08-28",
"certification_date": "2020-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MD",
"license": "25755",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in District Heights, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.