Individual provider Active NPI

Ilene S Gallner-Toller, LCSW-C

  • Clinical Social Worker
  • Columbia, MD
National Provider Identifier
1962427963
Registry record updated Nov 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
04011 Issued in MD
Practice address
10451 Twin Rivers Rd
Columbia, MD 21044-2388
Phone
(410) 977-3557
Fax
(410) 364-1791
NPI assigned
Jul 12, 2006
Last updated
Nov 26, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2007

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 04011 MD Primary

Addresses

Primary practice location

10451 Twin Rivers Rd
Columbia, MD 21044-2388

Mailing address

4623 Falls Rd
Baltimore, MD 21209-4914
Phone (410) 366-1980

Other identifiers 5

IdentifierTypeStateIssuer
272281OtherMDCOMPSYCH
T541-0031OtherMDBCBS-DC REGIONAL #
226089OtherMDKAISER
53085702OtherMDCAREFIRST BCBS
PVPB134858OtherMDAPS HEALTHCARE

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
I20070201000353 MD Practitioner - Clinical Social Worker 1052313228 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1981
Medicare assignment
May accept Medicare assignment
Group practices

Practice addresses (Care Compare)

10451 Twin Rivers Rd
Suite 100
Columbia, MD 21044-2332
Phone (410) 997-3557

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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, 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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196035200000",
    "number": "1962427963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4623 FALLS RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212094914",
            "telephone_number": "410-366-1980",
            "fax_number": "410-366-8530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10451 TWIN RIVERS RD",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210442388",
            "telephone_number": "410-977-3557",
            "fax_number": "410-364-1791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLNER-TOLLER",
        "first_name": "ILENE",
        "middle_name": "S",
        "credential": "LCSW-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2007-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "04011",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMPSYCH",
            "identifier": "272281",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS-DC REGIONAL #",
            "identifier": "T541-0031",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER",
            "identifier": "226089",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BCBS",
            "identifier": "53085702",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APS HEALTHCARE",
            "identifier": "PVPB134858",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

Verify at the official NPI Registry.