Individual provider Active NPI

James Earnest Skinner, LCSW-C

  • Clinical Social Worker
  • Gaithersburg, MD
National Provider Identifier
1992103816
Registry record updated Dec 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
14008 Issued in MD
Practice address
610 Professional Dr
Suite 255
Gaithersburg, MD 20879
Phone
(240) 683-6202
NPI assigned
Dec 9, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2014

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 14008 MD Primary

Addresses

Primary practice location

610 Professional Dr
Suite 255
Gaithersburg, MD 20879

Mailing address

610 Professional Dr
Suite 255
Gaithersburg, MD 20879
Phone (240) 683-6202

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20150630002655 DC Practitioner - Clinical Social Worker 2769794957 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Willow Oak Therapy Center, IncGroup PAC ID 5698661023, 18 clinicians

Practice addresses (Care Compare)

15701 Crabbs Branch Way
Rockville, MD 20855-2634
Phone (301) 251-8965

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14008MDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Willow Oak Therapy Center, Inc. CurrentSince May 21, 2021 Accepting new patients
Jody Tabner Thayer LLC Clinical PastSince May 21, 2021 Accepting new patients

Locations

15701 Crabbs Branch Way
Rockville, MD 20855
Phone (301) 251-8965

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1418083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418083200000",
    "number": "1992103816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 PROFESSIONAL DR",
            "address_2": "SUITE 255",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "20879",
            "telephone_number": "240-683-6202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 PROFESSIONAL DR",
            "address_2": "SUITE 255",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "20879",
            "telephone_number": "240-683-6202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKINNER",
        "first_name": "JAMES",
        "middle_name": "EARNEST",
        "credential": "LCSW-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-12-09",
        "last_updated": "2014-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "14008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gaithersburg, MD

Sources for this page

Verify at the official NPI Registry.