Matthew Ryan Slade, MSW,LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

22468 Issued in MD

Practice address

1311 Londontown Blvd Ste 130a
Eldersburg, MD 21784-6439

Phone

(410) 552-0773

Fax

(443) 200-0267

NPI assigned

Sep 30, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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 and National Provider Directory roles.

• Balanced Resilience Mental Health

  • Psychiatric/Mental Health Nurse Practitioner
  • Eldersburg, MD
  • NPI 1669337226

  Single Specialty

  NPD

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

{
    "created_epoch": "1569801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569801600000",
    "number": "1972144178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1229",
            "city": "SYKESVILLE",
            "state": "MD",
            "postal_code": "217841229",
            "telephone_number": "410-356-9208",
            "fax_number": "443-200-0267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1311 LONDONTOWN BLVD STE 130A",
            "city": "ELDERSBURG",
            "state": "MD",
            "postal_code": "217846439",
            "telephone_number": "410-552-0773",
            "fax_number": "443-200-0267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLADE",
        "first_name": "MATTHEW",
        "middle_name": "RYAN",
        "credential": "MSW,LMSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-09-30",
        "last_updated": "2019-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker",
            "state": "MD",
            "license": "22468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "office",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1311 Londontown Blvd Ste 130A",
            "city": "Eldersburg",
            "state": "MD",
            "country_code": "US",
            "postal_code": "217846439",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sinai Hospital of Baltimore, Inc.
• Sinai Hospital of Baltimore, Inc.
• Kiara Singleton
• Bethany Six
• Kara Slack, LCPC
• Smiles4Chidren
• Lisa Smirnow, D.O.
• Jessica Smith, LGPC
• Laura Ann Smith, RDH
• Tiffany Smith

• Social Worker in Eldersburg, MD
• Providers in Eldersburg, MD by specialty
• Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.