Individual provider Active NPI

Lynn Mahan, LCSW-C

  • Clinical Social Worker
  • Nottingham, MD
National Provider Identifier
1811087174
Registry record updated Jan 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
15958 Issued in MD
Practice address
4920 Campbell Blvd
Nottingham, MD 21236-5916
Phone
(410) 933-7761
NPI assigned
Oct 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 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 15958 MD Primary

Addresses

Primary practice location

4920 Campbell Blvd
Nottingham, MD 21236-5916

Mailing address

2101 E Jefferson St
Kaiser Permanente Medicare Enrollment
Rockville, MD 20852-4908
Phone (301) 816-2424

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, CO, MD, DC4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20070907000205 FL Practitioner - Clinical Social Worker 6507959509 Reassigns benefits to 1 organization
I20080205000674 CO Practitioner - Clinical Social Worker 6507959509 Reassigns benefits to 1 organization
I20131223000966 MD Practitioner - Clinical Social Worker 6507959509 Reassigns benefits to 1 organization
I20231109002188 DC Practitioner - Clinical Social Worker 6507959509 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Clinical CurrentSince Aug 29, 2023 Accepting new patients
Harvey L Gewanter PHD and Associates CurrentSince Nov 27, 2022 Accepting new patients
Senior Psych Solutions Corp Clinical Past Accepting new patients

Locations

5445 Dtc Pkwy
Ph 4
Greenwood Village, CO 80111
Phone (720) 571-4874

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

2833 Smith Ave
Ste 430
Baltimore, MD 21209
Phone (410) 686-9800

8300 Boone Blvd
Ste 500
Vienna, VA 22182
Phone (703) 884-2598

Organizations & group practices 3

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": "1160784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325635200000",
    "number": "1811087174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 E JEFFERSON ST",
            "address_2": "KAISER PERMANENTE MEDICARE ENROLLMENT",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208524908",
            "telephone_number": "301-816-2424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4920 CAMPBELL BLVD",
            "city": "NOTTINGHAM",
            "state": "MD",
            "postal_code": "212365916",
            "telephone_number": "410-933-7761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHAN",
        "first_name": "LYNN",
        "credential": "LCSW-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-14",
        "last_updated": "2012-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "15958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nottingham, MD

Sources for this page

Verify at the official NPI Registry.