Individual provider Active NPI

Adele Redisch, LCSW-C

  • Clinical Social Worker
  • Gaithersburg, MD
National Provider Identifier
1821152497
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
04751 Issued in MD
Practice address
16220 S Frederick Ave
Suite 512
Gaithersburg, MD 20877-4039
Phone
(301) 279-0546
NPI assigned
Dec 20, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 04751 MD Primary

Addresses

Primary practice location

16220 S Frederick Ave
Suite 512
Gaithersburg, MD 20877-4039

Mailing address

9420 Copenhaver Dr
Potomac, MD 20854-3024
Phone (301) 279-0546

Other identifiers 3

IdentifierTypeStateIssuer
191537OtherMDMHN
155567000OtherMAGELLAN
5685OtherMDCARE FIRST

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1821152497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9420 COPENHAVER DR",
            "city": "POTOMAC",
            "state": "MD",
            "postal_code": "208543024",
            "telephone_number": "301-279-0546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16220 S FREDERICK AVE",
            "address_2": "SUITE 512",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208774039",
            "telephone_number": "301-279-0546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDISCH",
        "first_name": "ADELE",
        "name_prefix": "Mrs.",
        "credential": "LCSW-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "04751",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHN",
            "identifier": "191537",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "155567000",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARE FIRST",
            "identifier": "5685",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gaithersburg, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.