Mark A Roeder, LCSW-C
Individual provider Active NPI Clinical Social Worker · Cumberland, MD
NPI 1780945386 · NPPES record last updated May 31, 2012
Key facts
- NPI
- 1780945386
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 06419 (MD)
- Practice address
- 12503 Willowbrook Rd
Cumberland, MD 21502-2554 - Phone
- (301) 759-5280
- Fax
- (301) 777-5630
- NPI assigned
- May 31, 2012
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 1985
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Allegany County Health Department
Practice addresses (Care Compare)
12501 Willowbrook Rd
Cumberland, MD 21502-2569
Phone (301) 759-5127
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MD
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20121010000041 | MD | Practitioner - Clinical Social Worker | 2567611452 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 06419 | MD | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Allegany County Health Department | Current |
Accepting new patients | |
| Allegany County Health Department | Current | Accepting new patients | |
| Allegany County Health Department/Joseph S Massie Unit | Current |
Accepting new patients |
Locations
12503 Willowbrook Rd
Cumberland, MD 21502
Phone (301) 759-5050
12501 Willowbrook Rd
Cumberland, MD 21502
Phone (301) 759-5000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 06419 | MD | Yes |
Addresses
Primary practice location
12503 Willowbrook Rd
Cumberland, MD 21502-2554
Mailing address
PO Box 1745
Cumberland, MD 21501-1745
Phone (301) 759-5280
Other providers in Cumberland, MD
- Robert J. Carpenter MD PA
- Kenrick Hamilton Roberts
- Patricia Robison
- Vanessa L Robosson
- Aleena Marie Rock
- Paul Steven Roeder
- Marcos Roffe
- David Alberto Rojas
- Verna Roman
- Donna Ross
All providers in Cumberland, MD · Clinical Social Worker in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 31, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.