Individual provider Active NPI

Janina Gunderson

  • Clinical Social Worker
  • Rockville, MD
National Provider Identifier
1801618467
Registry record updated Oct 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
32242 Issued in MD
Practice address
6010 Executive Blvd
Rockville, MD 20852-3809
Phone
(929) 688-3594
NPI assigned
Oct 25, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LG200003135 DC
Clinical Social Worker 1041C0700X 0903004323 VA
Clinical Social Worker 1041C0700X 124430 NY
Clinical Social Worker 1041C0700X 32242 MD Primary

Addresses

Primary practice location

6010 Executive Blvd
Rockville, MD 20852-3809

Mailing address

6010 Executive Blvd
Rockville, MD 20852-3809

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
LG200003135DCMDClinical Social Worker
32242MDMDClinical Social Worker
124430NYMDClinical Social Worker
0903004323VAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1729814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729814400000",
    "number": "1801618467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6010 EXECUTIVE BLVD",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208523809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6010 EXECUTIVE BLVD",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208523809",
            "telephone_number": "929-688-3594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUNDERSON",
        "first_name": "JANINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-25",
        "last_updated": "2024-10-25",
        "certification_date": "2024-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DC",
            "license": "LG200003135",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0903004323",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "124430",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "32242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2024; 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.