Angelique Alisia Brathwaite, LCSW-C

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

17166 Issued in MD

Practice address

5800 Annapolis Rd Apt 801
Bladensburg, MD 20710-2020

Phone

(410) 504-2776

NPI assigned

Sep 11, 2011

Last updated

Sep 11, 2011By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD, GA2 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 2

Specialty

Clinical Social Worker

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Changing Lives at Home Mental Health CorporationGroup PAC ID 7719273788, 3 clinicians

Practice addresses (Care Compare)

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.

• Changing Lives at Home Mental Health Corporation

  • Community/Behavioral Health Agency
  • Baltimore, MD
  • NPI 1912354184
  Medicare reassignment Care Compare group
• Backpack Medical Group, P.C.

  • Clinical Social Worker
  • Elkridge, MD
  • NPI 1851177570

  GA

  Medicare reassignment NPD
• A to X Clinical Consulting, LLC

  • Clinical Social Worker
  • Bowie, MD
  • NPI 1174488308
  NPD Authorized official
• Linnel Inc

  dba Backpack Healthcare Inc

  • Psychiatric/Mental Health Nurse Practitioner
  • Elkridge, MD
  • NPI 1932795044
  NPD (past)

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

{
    "created_epoch": "1315699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315699200000",
    "number": "1952683484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5800 ANNAPOLIS RD APT 801",
            "city": "BLADENSBURG",
            "state": "MD",
            "postal_code": "207102020",
            "telephone_number": "410-504-2776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5800 ANNAPOLIS RD APT 801",
            "city": "BLADENSBURG",
            "state": "MD",
            "postal_code": "207102020",
            "telephone_number": "410-504-2776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRATHWAITE",
        "first_name": "ANGELIQUE",
        "middle_name": "ALISIA",
        "name_prefix": "Ms.",
        "credential": "LCSW-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-11",
        "last_updated": "2011-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "17166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bilikis Adejoke Bello I
• Biniam Bereke Ocbamichael
• William Jamal Blackstone
• Bladensburg Volunteer Fire Department & Rescue
• BML Wellness, LLC
• Vanessa Dora Cheuji Fogta
• City Dermatology, LLC
• Camael Clarke, MPT, DPT
• Carole Staley Collins, PHD,MSN,RN
• Omofolake Abike Dada

• Clinical Social Worker in Bladensburg, MD
• Providers in Bladensburg, 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 Sep 11, 2011; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.