Individual provider Active NPI

Gertrud Irmgard Classen-Miller, LCSW-C

  • Clinical Social Worker
  • North Potomac, MD
National Provider Identifier
1942257142
Registry record updated May 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
07197 Issued in MD
Practice address
13111 Moran CT
North Potomac, MD 20878-3922
Phone
(301) 977-0824
Fax
(240) 597-0794
NPI assigned
May 31, 2006
Last updated
May 20, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2014

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 07197 MD Primary

Addresses

Primary practice location

13111 Moran CT
North Potomac, MD 20878-3922

Mailing address

13111 Moran CT
North Potomac, MD 20878-3922
Phone (301) 977-0824

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20111207000531 DC Practitioner - Clinical Social Worker 0345415014 Practice locations: Rockville, MD; North Potomac, MD

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

13111 Moran CT
North Potomac, MD 20878-3922
Phone (301) 977-0824

5880 Hubbard Dr
Rockville, MD 20852-4821
Phone (301) 977-0824

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
07197MDMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Town Center Psychiatric Assoc PastSince Feb 12, 1998 Accepting new patients

Organizations & group practices 3

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": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400544000000",
    "number": "1942257142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13111 MORAN CT",
            "city": "NORTH POTOMAC",
            "state": "MD",
            "postal_code": "208783922",
            "telephone_number": "301-977-0824",
            "fax_number": "240-597-0794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13111 MORAN CT",
            "city": "NORTH POTOMAC",
            "state": "MD",
            "postal_code": "208783922",
            "telephone_number": "301-977-0824",
            "fax_number": "240-597-0794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLASSEN-MILLER",
        "first_name": "GERTRUD",
        "middle_name": "IRMGARD",
        "credential": "LCSW-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-31",
        "last_updated": "2014-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "07197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Potomac, MD

Sources for this page

Verify at the official NPI Registry.