Individual provider Active NPI

Thinh Nguyen, LCSW-C

  • Clinical Social Worker
  • Baltimore, MD
National Provider Identifier
1881856698
Registry record updated Jan 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
17433 Issued in MD
Practice address
4419 Falls Rd Ste E
Baltimore, MD 21211-1296
Phone
(410) 262-9894
NPI assigned
Jul 2, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2024

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 17433 MD Primary

Addresses

Primary practice location

4419 Falls Rd Ste E
Baltimore, MD 21211-1296

Mailing address

4419 Falls Rd Ste E
Baltimore, MD 21211-1296
Phone (410) 262-9894

Other practice location 1

8 W Lake Ave
Baltimore, MD 21210-1304
Phone (410) 262-9894

Other identifiers 1

IdentifierTypeStateIssuer
0629770000MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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 1

Enrollment IDStateProvider typePAC IDDetails
I20120411000503 MD Practitioner - Clinical Social Worker 4789845165 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Living DeliberatelyGroup PAC ID 0244772622, 4 clinicians

Practice addresses (Care Compare)

4419 Falls Rd
Baltimore, MD 21211-1226
Phone (410) 262-9894

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
17433MDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Living Deliberately Clinical CurrentSince Apr 23, 2024 Accepting new patients
Evolve Deliberately, LLC Clinical Current Accepting new patients

Locations

4419 Falls Rd
Ste E
Baltimore, MD 21211
Phone (410) 578-0336

4419 Falls Rd
Baltimore, MD 21211
Phone (410) 262-9894

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1214956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705881600000",
    "number": "1881856698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4419 FALLS RD STE E",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212111296",
            "telephone_number": "410-262-9894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4419 FALLS RD STE E",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212111296",
            "telephone_number": "410-262-9894"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8 W Lake Ave",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212101304",
            "country_code": "US",
            "telephone_number": "410-262-9894",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "THINH",
        "credential": "LCSW-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-02",
        "last_updated": "2024-01-22",
        "certification_date": "2024-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "17433",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0629770000",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.