Individual provider Active NPI

Elizabeth Eleanor Gargano, LCSW-C

  • Clinical Social Worker
  • Baltimore, MD
National Provider Identifier
1912158734
Registry record updated May 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
15961 Issued in MD
Practice address
3900 Loch Raven Blvd
Loch Raven Community Living Center- 1C-12
Baltimore, MD 21218-2108
Phone
(410) 605-7556
NPI assigned
Oct 10, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 12, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X
Clinical Social Worker 1041C0700X 15961 MD Primary

Addresses

Primary practice location

3900 Loch Raven Blvd
Loch Raven Community Living Center- 1C-12
Baltimore, MD 21218-2108

Mailing address

3900 Loch Raven Blvd
Baltimore, MD 21218-2108
Phone (410) 605-7556

Other names 1

  • Elizabeth Eleanor Grillo Other name

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

State licenses

LicenseStateTypeSpecialty
15961MDMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1223596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463011200000",
    "number": "1912158734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 LOCH RAVEN BLVD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212182108",
            "telephone_number": "410-605-7556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 LOCH RAVEN BLVD",
            "address_2": "LOCH RAVEN COMMUNITY LIVING CENTER- 1C-12",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212182108",
            "telephone_number": "410-605-7556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARGANO",
        "first_name": "ELIZABETH",
        "middle_name": "ELEANOR",
        "credential": "LCSW-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-10",
        "last_updated": "2016-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "15961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "GRILLO",
            "middle_name": "ELEANOR",
            "credential": "MSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2016; 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.