Individual provider Active NPI

Annemarie Vallonga, LCSW-C

  • Clinical Social Worker
  • Baltimore, MD
National Provider Identifier
1922445949
Registry record updated Nov 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
949 Gorsuch Ave
Baltimore, MD 21218-3602
Phone
(410) 467-4121
Fax
(410) 467-6709
NPI assigned
May 31, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2021

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

949 Gorsuch Ave
Baltimore, MD 21218-3602

Mailing address

949 Gorsuch Ave
Baltimore, MD 21218-3602
Phone (410) 467-4121

Other names 1

  • Annemarie Eaton Former name

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
I20130722000017 MD Practitioner - Clinical Social Worker 7012158850

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13213MDMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Inspirit Counseling Services, Inc. Clinical CurrentSince Jun 8, 2013 Accepting new patients

Locations

5407 N Charles St
Baltimore, MD 21210
Phone (410) 433-2241

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1369958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637539200000",
    "number": "1922445949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "949 GORSUCH AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212183602",
            "telephone_number": "410-467-4121",
            "fax_number": "410-467-6709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "949 GORSUCH AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212183602",
            "telephone_number": "410-467-4121",
            "fax_number": "410-467-6709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALLONGA",
        "first_name": "ANNEMARIE",
        "credential": "LCSW-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-31",
        "last_updated": "2021-11-22",
        "certification_date": "2021-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNEMARIE",
            "last_name": "EATON",
            "credential": "LCSW-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.