Active NPI
David Blakemore, LCSW-C
- Clinical Social Worker
- Silver Spring, MD
National Provider Identifier
1851313951
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 10291
- Practice address
- 1107 Spring St
A3
Silver Spring, MD 20910-4027 - Phone
- (240) 353-0661
- Fax
- (301) 589-9129
- NPI assigned
- Jul 25, 2006
- Last updated
- Jul 8, 2007
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 10291 | MD | Primary |
Addresses
Primary practice location
1107 Spring St
A3
Silver Spring, MD 20910-4027
Mailing address
1107 Spring St
A3
Silver Spring, MD 20910-4027
Phone (240) 353-0661
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| K2660001 | Other | BLUECROSS BLUESHIELD |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10291 | MD | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Washington Assessment & Therapy Services | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Ronald D Wynne PhD
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Kensington, MD
- NPI 1689710022
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1851313951",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1107 SPRING ST",
"address_2": "A3",
"city": "SILVER SPRING",
"state": "MD",
"postal_code": "209104027",
"telephone_number": "240-353-0661",
"fax_number": "301-589-9129"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1107 SPRING ST",
"address_2": "A3",
"city": "SILVER SPRING",
"state": "MD",
"postal_code": "209104027",
"telephone_number": "240-353-0661",
"fax_number": "301-589-9129"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLAKEMORE",
"first_name": "DAVID",
"name_prefix": "Mr.",
"credential": "LCSW-C",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MD",
"license": "10291",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECROSS BLUESHIELD",
"identifier": "K2660001",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Silver Spring, 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.