Scott David Hetman, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

32416 Issued in MD

Practice address

2701 Eastern Blvd
Base Support BLDG Room 201
Middle River, MD 21220

Phone

(410) 918-6558

NPI assigned

Jun 8, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1623110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735603200000",
    "number": "1972170900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 EASTERN BLVD",
            "address_2": "BASE SUPPORT BLDG ROOM 201",
            "city": "MIDDLE RIVER",
            "state": "MD",
            "postal_code": "21220",
            "telephone_number": "410-918-6558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 EASTERN BLVD",
            "address_2": "BASE SUPPORT BLDG ROOM 201",
            "city": "MIDDLE RIVER",
            "state": "MD",
            "postal_code": "21220",
            "telephone_number": "410-918-6558"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "900 Bestgate Rd Ste 210",
            "address_purpose": "LOCATION",
            "city": "Annapolis",
            "state": "MD",
            "postal_code": "214017922",
            "country_code": "US",
            "telephone_number": "410-267-3706",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HETMAN",
        "first_name": "SCOTT",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-08",
        "last_updated": "2024-12-31",
        "certification_date": "2024-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "VA",
            "license": "0903003166",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904014910",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "32416",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Middle River, MD
• Providers in Middle River, 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 Dec 31, 2024; 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.