Individual provider Active NPI

Dorthea Lynn Crenshaw, LICSW, LCSW

  • Clinical Social Worker
  • Fort Washington, MD
National Provider Identifier
1992147524
Registry record updated Jul 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC50078134 Issued in DC
Practice address
938 E Swan Creek Rd Ste 739
Fort Washington, MD 20744-5250
Phone
(202) 997-4771
NPI assigned
Jul 24, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 24, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LC50078134 DC Primary
Clinical Social Worker 1041C0700X 0904007703 VA

Addresses

Primary practice location

938 E Swan Creek Rd Ste 739
Fort Washington, MD 20744-5250

Mailing address

938 E Swan Creek Rd Ste 739
Fort Washington, MD 20744-5250
Phone (202) 997-4771

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
I20141010001768 DC Practitioner - Clinical Social Worker 3779703970 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

8957 Edmonston Rd
Suite C
Greenbelt, MD 20770-4044
Phone (202) 815-5525

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Maryland Health Alliance, Inc. Clinical CurrentSince Feb 27, 2019 Accepting new patients
Vita Abbodante LLC Clinical CurrentSince Aug 4, 2020 Accepting new patients
Safe Harbor Behavioral Care, LLC Clinical PastSince Mar 7, 2023 Accepting new patients

Locations

7525 Greenway Center Dr
Ste 207
Greenbelt, MD 20770
Phone (240) 473-2159

8843 Greenbelt Rd
Greenbelt, MD 20770
Phone (202) 689-4398

8957 Edmonston Rd
Ste C
Greenbelt, MD 20770
Phone (202) 815-5525

Organizations & group practices 4

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": "1374624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374624000000",
    "number": "1992147524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "938 E SWAN CREEK RD STE 739",
            "city": "FORT WASHINGTON",
            "state": "MD",
            "postal_code": "207445250",
            "telephone_number": "202-997-4771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "938 E SWAN CREEK RD STE 739",
            "city": "FORT WASHINGTON",
            "state": "MD",
            "postal_code": "207445250",
            "telephone_number": "202-997-4771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRENSHAW",
        "first_name": "DORTHEA",
        "middle_name": "LYNN",
        "credential": "LICSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-24",
        "last_updated": "2013-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DC",
            "license": "LC50078134",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904007703",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Washington, MD

Sources for this page

Verify at the official NPI Registry.