Individual provider Active NPI

Tonilee Lucchino, LCSW-C, RPT

  • Clinical Social Worker
  • Columbia, MD
National Provider Identifier
1821445545
Registry record updated Oct 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
17721 Issued in MD
Practice address
5500 Knoll North Dr Ste 370
Columbia, MD 21045-2393
Phone
(410) 837-2050
NPI assigned
May 23, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 17721 MD
Clinical Social Worker 1041C0700X 17721 MD Primary

Addresses

Primary practice location

5500 Knoll North Dr Ste 370
Columbia, MD 21045-2393

Mailing address

5500 Knoll North Dr Ste 370
Columbia, MD 21045-2393
Phone (410) 837-2050

Other identifiers 1

IdentifierTypeStateIssuer
104100000XMedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20210831000594 MD Practitioner - Clinical Social Worker 3779989793 Reassigns benefits to 2 organizations
I20241112003469 DC Practitioner - Clinical Social Worker 3779989793 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
17721MDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Behavioral Health, Inc CurrentSince Jun 1, 2021 Accepting new patients
Chase Brexton Health Services, Inc. CurrentSince Nov 21, 2022 Accepting new patients
Montgomery Wellness Hub LLC CurrentSince Sep 1, 2024 Accepting new patients
Chase Brexton Health Services, Inc. CurrentSince Nov 21, 2022 Accepting new patients

Locations

1111 N Charles St
Baltimore, MD 21201
Phone (410) 486-5991

5500 Knoll North Dr
Ste 370
Columbia, MD 21045
Phone (410) 884-7831

1003 W 7th St
Ste 500
Frederick, MD 21701
Phone (240) 297-1567

951 Russell Ave
Ste D
Gaithersburg, MD 20879
Phone (240) 246-7837

Organizations & group practices 4

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": "1463961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666742400000",
    "number": "1821445545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 KNOLL NORTH DR STE 370",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210452393",
            "telephone_number": "410-837-2050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 KNOLL NORTH DR STE 370",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210452393",
            "telephone_number": "410-837-2050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCCHINO",
        "first_name": "TONILEE",
        "credential": "LCSW-C, RPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-23",
        "last_updated": "2022-10-26",
        "certification_date": "2022-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MD",
            "license": "17721",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "17721",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104100000X",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

Verify at the official NPI Registry.