Individual provider Active NPI

Tanya Renee Peete, LCSW-C, LMSW

  • Clinical Social Worker
  • Baltimore, MD
National Provider Identifier
1881902765
Registry record updated Jul 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
2601 Pennsylvania Ave
Baltimore, MD 21217-1817
Phone
(248) 805-2422
NPI assigned
Sep 14, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 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 Primary

Addresses

Primary practice location

2601 Pennsylvania Ave
Baltimore, MD 21217-1817

Mailing address

51134 Federal Blvd
Canton, MI 48188-2482
Phone (248) 805-2422

Other practice location 1

1127 S Old US Highway 23
Brighton, MI 48114-9681
Phone (248) 805-2422

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC, MI3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20151120002008 MD Practitioner - Clinical Social Worker 2961702055 Reassigns benefits to 1 organization
I20151120002147 DC Practitioner - Clinical Social Worker 2961702055 Reassigns benefits to 2 organizations
I20170710002624 MI Practitioner - Clinical Social Worker 2961702055 Practice locations: Brighton, MI

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18732MDMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Journey to Empowerment Clinical CurrentSince Jul 28, 2024 Accepting new patients
Premier Health Care, LLC CurrentSince Jan 20, 2016 Accepting new patients
Mindfulness Journey Inc Current Accepting new patients
Mindfulness Journey Counseling PLLC CurrentSince Oct 19, 2024 Accepting new patients
Premier Health Care LLC CurrentSince Jan 20, 2016 Accepting new patients
Della Behavioral Health Services CurrentSince Oct 28, 2015 Accepting new patients

Locations

2601 Pennsylvania Ave
Baltimore, MD 21217
Phone (248) 702-5544

9841 Broken Land Pkwy
Ste 314
Columbia, MD 21046
Phone (410) 929-7225

12073 Tech Rd
Ste B
Silver Spring, MD 20904
Phone (240) 396-5873

440 Monticello Ave
Ste 1802
Norfolk, VA 23510
Phone (757) 447-4335

Organizations & group practices 6

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": "1284422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721520000000",
    "number": "1881902765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51134 FEDERAL BLVD",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481882482",
            "telephone_number": "248-805-2422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 PENNSYLVANIA AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212171817",
            "telephone_number": "248-805-2422"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1127 S Old US Highway 23",
            "address_purpose": "LOCATION",
            "city": "Brighton",
            "state": "MI",
            "postal_code": "481149681",
            "country_code": "US",
            "telephone_number": "248-805-2422",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEETE",
        "first_name": "TANYA",
        "middle_name": "RENEE",
        "credential": "LCSW-C, LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-14",
        "last_updated": "2024-07-21",
        "certification_date": "2024-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.