NPIMap

Organization Active NPI

Constance W. Pullen

  • Clinical Social Worker
  • Royal Oak, MD
National Provider Identifier
1770237786
Registry record updated Feb 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
CONSTANCE W. PULLEN
Practice address
25800 Avonia LN
Royal Oak, MD 21662-1417
Phone
(410) 822-6501
NPI assigned
Feb 8, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2022

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

Authorized official

Name
Constance W. Pullen, LCSW-CNPI 1790872513
Title
Owner
Phone
(410) 822-6501

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

25800 Avonia LN
Royal Oak, MD 21662-1417

Mailing address

25800 Avonia LN
Royal Oak, MD 21662-1417
Phone (410) 822-6501

Other identifiers 1

IdentifierTypeStateIssuer
160241100MedicaidMD

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1644278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644278400000",
    "number": "1770237786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25800 AVONIA LN",
            "city": "ROYAL OAK",
            "state": "MD",
            "postal_code": "216621417",
            "telephone_number": "410-822-6501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25800 AVONIA LN",
            "city": "ROYAL OAK",
            "state": "MD",
            "postal_code": "216621417",
            "telephone_number": "410-822-6501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONSTANCE W. PULLEN",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-08",
        "last_updated": "2022-02-08",
        "certification_date": "2022-02-08",
        "status": "A",
        "authorized_official_last_name": "PULLEN",
        "authorized_official_first_name": "CONSTANCE",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-822-6501",
        "authorized_official_credential": "LCSW-C"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "160241100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Royal Oak, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.