Individual provider Active NPI

Nancy Ebb, LCSW C

  • Clinical Social Worker
  • Gaithersburg, MD
National Provider Identifier
1992866891
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
12169 Issued in MD
Practice address
16220 S Frederick Avenue
Suite 502
Gaithersburg, MD 20877-4022
Phone
(301) 978-9750
Fax
(301) 978-9753
NPI assigned
Dec 13, 2006
Sex
Female
Sole proprietor
No

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 12169 MD Primary

Addresses

Primary practice location

16220 S Frederick Avenue
Suite 502
Gaithersburg, MD 20877-4022

Mailing address

16220 S Frederick Avenue
Suite 502
Gaithersburg, MD 20877-4022
Phone (301) 978-9750

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
I20150925001034 DC Practitioner - Clinical Social Worker 1951619840 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12169MDMDSchool Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Nancy Ebb LLC Clinical CurrentSince May 17, 2019 Accepting new patients

Locations

4405 East West Hwy
Ste 501
Bethesda, MD 20814
Phone (240) 476-8764

Organizations & group practices 1

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": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992866891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16220 S FREDERICK AVENUE",
            "address_2": "SUITE 502",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208774022",
            "telephone_number": "301-978-9750",
            "fax_number": "301-978-9753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16220 S FREDERICK AVENUE",
            "address_2": "SUITE 502",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208774022",
            "telephone_number": "301-978-9750",
            "fax_number": "301-978-9753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBB",
        "first_name": "NANCY",
        "name_prefix": "Ms.",
        "credential": "LCSW C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "12169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gaithersburg, MD

Sources for this page

Verify at the official NPI Registry.