Active NPI
Llewellyn Cornelius, PH.D., LCSW
- Social Worker
- Odenton, MD
National Provider Identifier
1821601469
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 11763
- Practice address
- 306 Gatehouse LN Apt H
Odenton, MD 21113-2838 - Phone
- (443) 934-5034
- NPI assigned
- Aug 24, 2020
- Sex
- Male
- Sole proprietor
- Yes
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 | 11763 | MD | Primary |
Addresses
Primary practice location
306 Gatehouse LN Apt H
Odenton, MD 21113-2838
Mailing address
1025 Hillary LN
Lawrenceville, GA 30043-6699
Phone (443) 934-5034
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11763 | MD | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1598227200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1598227200000",
"number": "1821601469",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1025 HILLARY LN",
"city": "LAWRENCEVILLE",
"state": "GA",
"postal_code": "300436699",
"telephone_number": "443-934-5034"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "306 GATEHOUSE LN APT H",
"city": "ODENTON",
"state": "MD",
"postal_code": "211132838",
"telephone_number": "443-934-5034"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORNELIUS",
"first_name": "LLEWELLYN",
"name_prefix": "Prof.",
"credential": "PH.D., LCSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-08-24",
"last_updated": "2020-08-24",
"certification_date": "2020-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Social Worker",
"state": "MD",
"license": "11763",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Odenton, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.