Individual provider Active NPI

Jean L. Wyman, LCSW-C

  • Clinical Social Worker
  • Towson, MD
National Provider Identifier
1780887489
Registry record updated Nov 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
13145 Issued in MD
Practice address
6525 N Charles St
Gibson Building Office 132
Towson, MD 21204-6872
Phone
(410) 433-1583
NPI assigned
Jun 8, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 13145 MD Primary

Addresses

Primary practice location

6525 N Charles St
Gibson Building Office 132
Towson, MD 21204-6872

Mailing address

6525 N Charles St
Gibson Building Office 132
Towson, MD 21204-6872
Phone (410) 433-1583

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

LicenseStateTypeSpecialty
13145MDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Jean L. Wyman, LCSW-C, Inc. Clinical Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1181260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352160000000",
    "number": "1780887489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6525 N CHARLES ST",
            "address_2": "GIBSON BUILDING OFFICE 132",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212046872",
            "telephone_number": "410-433-1583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6525 N CHARLES ST",
            "address_2": "GIBSON BUILDING OFFICE 132",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212046872",
            "telephone_number": "410-433-1583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYMAN",
        "first_name": "JEAN",
        "middle_name": "L.",
        "name_prefix": "Ms.",
        "credential": "LCSW-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-08",
        "last_updated": "2012-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "13145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Towson, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2012; 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.