Active NPI
Heather Coudon, LMSW
- Social Worker
- North East, MD
National Provider Identifier
1790250819
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 23735
- Practice address
- 102 E Cecil Ave Ste D
North East, MD 21901-4057 - Phone
- (443) 877-6959
- Fax
- (443) 281-0111
- NPI assigned
- Oct 4, 2018
- Last updated
- Oct 4, 2018
- Sex
- Female
- Sole proprietor
- No
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 | 23735 | MD | Primary |
Addresses
Primary practice location
102 E Cecil Ave Ste D
North East, MD 21901-4057
Mailing address
102 E Cecil Ave Ste D
North East, MD 21901-4057
Phone (443) 877-6959
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 |
|---|---|---|---|
| 23735 | MD | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1538611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1538611200000",
"number": "1790250819",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "102 E CECIL AVE STE D",
"city": "NORTH EAST",
"state": "MD",
"postal_code": "219014057",
"telephone_number": "443-877-6959",
"fax_number": "443-281-0111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "102 E CECIL AVE STE D",
"city": "NORTH EAST",
"state": "MD",
"postal_code": "219014057",
"telephone_number": "443-877-6959",
"fax_number": "443-281-0111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COUDON",
"first_name": "HEATHER",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-10-04",
"last_updated": "2018-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MD",
"license": "23735",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North East, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.