Patricia Moody Jefferson, MSW, LCSW-C, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

23101 Issued in MD

Practice address

3405 W Forest Park Ave
Baltimore, MD 21216-1426

Phone

(443) 928-3121

Fax

(410) 744-4253

NPI assigned

Jul 6, 2009

Last updated

Mar 20, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Patricia Moody Jefferson Professional name

Medicare fee-for-service enrollment

Enrolled in GA, DC, NJ3 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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Grow Healthcare Group of New Jersey PC

  • Mental Health Counselor
  • Hoboken, NJ
  • NPI 1841949328

  Clinical

  Medicare reassignment NPD
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  Clinical, DC, GA

  Medicare reassignment NPD

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

{
    "created_epoch": "1246838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584662400000",
    "number": "1932338449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3405 W FOREST PARK AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212161426",
            "telephone_number": "443-928-3121",
            "fax_number": "410-744-4253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3405 W FOREST PARK AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212161426",
            "telephone_number": "443-928-3121",
            "fax_number": "410-744-4253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEFFERSON",
        "first_name": "PATRICIA",
        "middle_name": "MOODY",
        "name_prefix": "Ms.",
        "credential": "MSW, LCSW-C, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-06",
        "last_updated": "2020-03-20",
        "certification_date": "2020-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW006738",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "23101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PATRICIA",
            "last_name": "JEFFERSON",
            "middle_name": "MOODY",
            "credential": "MSW, LCSW-C, LCSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Devon Rumelo Jeffers, M.D.
• Justin Jeffers
• Artrish Jefferson, MD
• Jaimon Jefferson
• Lamont Jefferson
• Samantha Brooke Jefferson, LCSW-C
• Tyrahna Jefferson, CRANIAL PROSTHESIS
• Dean Thomas Jeffery, M.D., FRCPC
• Monifa S Jeffrey-Riggins, MSW, LCSWC
• Ronald D. Jeffreys, D.O.

• Clinical Social Worker in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.