NPIMap

Organization Active NPI

One Source Wellness Works LLC

  • Clinical Social Worker
  • Towson, MD
National Provider Identifier
1851033740
Registry record updated Apr 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
ONE SOURCE WELLNESS WORKS LLC
Practice address
22 W Pennsylvania Ave Ste 410
Towson, MD 21204-5017
Phone
(478) 397-9624
NPI assigned
Apr 11, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2022

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

Authorized official

Name
Maxwell Manning, LCSWC
Title
Clinical Director
Phone
(301) 252-4392

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

22 W Pennsylvania Ave Ste 410
Towson, MD 21204-5017

Mailing address

22 W Pennsylvania Ave Ste 410
Towson, MD 21204-5017
Phone (478) 397-9624

Other identifiers 1

IdentifierTypeStateIssuer
1730415498MedicaidMD

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL https://onesourcewellnessworks.com/ Health Information Exchange (HIE)

National Provider Directory

National Provider Directory
Tax ID family
One Source Wellness Works LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

22 W Pennsylvania Ave
Ste 410
Towson, MD 21204
Phone (478) 397-9624

NPI Registry JSON

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

{
    "created_epoch": "1649635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649635200000",
    "number": "1851033740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 W PENNSYLVANIA AVE STE 410",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212045017",
            "telephone_number": "478-397-9624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 W PENNSYLVANIA AVE STE 410",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212045017",
            "telephone_number": "478-397-9624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ONE SOURCE WELLNESS WORKS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-11",
        "last_updated": "2022-04-11",
        "certification_date": "2022-04-11",
        "status": "A",
        "authorized_official_last_name": "MANNING",
        "authorized_official_first_name": "MAXWELL",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "301-252-4392",
        "authorized_official_credential": "LCSWC"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1730415498",
            "state": "MD"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://onesourcewellnessworks.com/",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "22 W Pennsylvania Ave Ste 410",
            "city": "Towson",
            "state": "MD",
            "country_code": "US",
            "postal_code": "212045017",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Towson, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2022; 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.