Individual provider Active NPI

Ann M Dobbertin, LCSW-C

  • Clinical Social Worker
  • Hyattsville, MD
National Provider Identifier
1982746038
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
MD05910 Issued in MD
Practice address
3320 Stanford St
Hyattsville, MD 20783-1948
Phone
(301) 422-0101
Fax
(301) 422-0101
NPI assigned
Feb 13, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 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 MD05910 MD Primary

Addresses

Primary practice location

3320 Stanford St
Hyattsville, MD 20783-1948

Mailing address

3320 Stanford St
Hyattsville, MD 20783-1948
Phone (301) 422-0101

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Oct 1, 2012 through Oct 1, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
05910MDMDPsychologist
MD05910MDMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1982746038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3320 STANFORD ST",
            "city": "HYATTSVILLE",
            "state": "MD",
            "postal_code": "207831948",
            "telephone_number": "301-422-0101",
            "fax_number": "301-422-0101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3320 STANFORD ST",
            "city": "HYATTSVILLE",
            "state": "MD",
            "postal_code": "207831948",
            "telephone_number": "301-422-0101",
            "fax_number": "301-422-0101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOBBERTIN",
        "first_name": "ANN",
        "middle_name": "M",
        "credential": "LCSW-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "MD05910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hyattsville, MD

Sources for this page

Verify at the official NPI Registry.