Individual provider Active NPI

Merissa Brown, LCSW-C

  • Social Worker
  • Baltimore, MD
National Provider Identifier
1790177640
Registry record updated Dec 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
19550 Issued in MD
Practice address
4709 Harford Road
Suite a, 2ND FL #11
Baltimore, MD 21214-3261
Phone
(410) 648-9707
Fax
(410) 878-7344
NPI assigned
Mar 2, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 19550 MD Primary

Addresses

Primary practice location

4709 Harford Road
Suite a, 2ND FL #11
Baltimore, MD 21214-3261

Mailing address

4709 Harford Road
Suite a, 2ND FL #11
Baltimore, MD 21214-3261
Phone (410) 648-9707

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160519000095 MD Practitioner - Clinical Social Worker 3870882525 Reassigns benefits to 1 organization
Practice locations: Baltimore, MD

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
19550MDMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Salus Health Inc CurrentSince Aug 29, 2022 Accepting new patients

Locations

1020 Saint Paul St
Baltimore, MD 21202
Phone (410) 529-0348

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": "1425254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607472000000",
    "number": "1790177640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4709 HARFORD ROAD",
            "address_2": "SUITE A, 2ND FL #11",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212143261",
            "telephone_number": "410-648-9707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4709 HARFORD ROAD",
            "address_2": "SUITE A, 2ND FL #11",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212143261",
            "telephone_number": "410-648-9707",
            "fax_number": "410-878-7344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "MERISSA",
        "credential": "LCSW-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-02",
        "last_updated": "2020-12-09",
        "certification_date": "2020-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MD",
            "license": "19550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.