MRS. MARY E KAUL BLACK (NPI# 1215006598) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215006598 |
| Entity Type | Individual |
| Full Name | MRS. MARY E KAUL BLACK |
| Credential | LCSW C |
| Practice Address |
10776 Grays Corner Rd. Suite 2 Berlin MD 21811 |
| Practice Telephone | 4102137875 |
| Practice Fax Number | 4102137877 |
| Mailing Telephone | 4102137875 |
| Mailing Fax Number | 4102137877 |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2016-11-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
11018 | MD | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | CAREFIRST BCBS PIN | 60956202 | 01 |
| MD | 609550001 | 05 | |
| MD | AETNA | 522156095 | 01 |
| AMERICAN PSYCH SYSTEM | 100075562001 | 01 | |
| UNITED HEALTH CARE MAMSI | 2101170 | 01 | |
| MD | MAGELLAN GROUP | 259147000 | 01 |
| MD | UNITED BEHAVIORAL HEALTH | 522156095 | 01 |
| CAREFIRST FEDERAL PIN DC | 0006 | 01 | |
| MD | MAGELLAN PIN | 269292000 | 01 |
| UHC MAMSI GROUP # | 517251 | 01 | |
| NCPPO PIN | 724333 | 01 | |
| MD | CAREFIRST BCBS GROUP | LM49EA | 01 |
| CARE1ST FEDERAL GROUP DC | R968 | 01 |
| Street Address |
10776 GRAYS CORNER RD. SUITE 2 |
| City | BERLIN |
| State | MD |
| Zip Code | 21811 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922410109 | Seaside Counseling & Wellness Center | Counselor | 10776 Grays Corner Rd., Suite 2, Berlin, MD 21811 | 2014-05-22 |
| 1710221031 | Amber K Penuel | Psychologist | 10776 Grays Corner Rd., Suite 2, Berlin, MD 21811 | 2012-11-27 |
| 1285905208 | Jessica Megary Hagy | Social Worker | 10776 Grays Corner Rd., Suite 2, Berlin, MD 21811 | 2012-01-23 |
| 1326179813 | Amy P Ginnavan | Counselor | 10776 Grays Corner Rd., Suite 2, Berlin, MD 21811 | 2007-03-08 |
| 1306975446 | Debra Ann Dotson | Social Worker | 10776 Grays Corner Rd., Suite 2, Berlin, MD 21811 | 2007-03-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366912909 | Kathleen Cathell | Speech-Language Pathologist | 11187 Racetrack Rd, Berlin, MD 21811 | 2018-11-27 |
| 1033613336 | Kimberly Rose Richardson | Registered Nurse | Atlantic General Hospital, 9733 Healthway Dr, Berlin, MD 21811 | 2018-03-21 |
| 1780108514 | Jayme Sroka Mahoney | Marriage & Family Therapist | 124 N. Main St. Ste. C, Berlin, MD 21811 | 2017-08-02 |
| 1013332543 | Ray Charles Lockamy Jr. | Behavior Technician | 10514 Racetrack Rd Ste G, Berlin, MD 21811 | 2014-02-20 |
| 1972845121 | Timothy Pearson | Dermatology | 9948 N. Main St., Berlin, MD 21811 | 2013-03-25 |
| 1710248315 | Jaime Farrell Coates | Counselor | 378 Schooner Ln, Berlin, MD 21811 | 2012-05-31 |
| 1902185697 | Lee Ahlstrom | Pharmacist | 11307 Manklin Creek Rd, Berlin, MD 21811 | 2011-08-11 |
| 1780987677 | Worcester County Health Department | Public Health or Welfare | 107 Williams Street, Worcester County Health Department Dental Center, Berlin, MD 21811 | 2010-12-15 |
| 1942511563 | Corey Lee Smith | Dentist | 11204 Racetrack Rd Ste 102, Berlin, MD 21811 | 2010-06-29 |
| 1255656062 | Sarah Mae Brown | Pharmacist | Apple Discount Drugs 314 Franklin Avenue, Berlin, MD 21811 | 2010-04-05 |
| Find all providers in zip 21811 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710460746 | Karen Schultz | Social Worker | 36 Brigham Rd, Berlin, MA 01503-1620 | 2018-09-14 |
| 1174018667 | Juliet Davis | Social Worker | 641 Comstock Rd Ste 1, Berlin, VT 05602-9611 | 2018-06-27 |
| 1053801902 | Acadia Counseling and Wellness | Social Worker | 9954 N Main St Bldg 2, Berlin, MD 21811-1076 | 2018-05-16 |
| 1144652579 | Tyler Betz | Social Worker | 6 Grace St, Berlin, MD 21811-1423 | 2013-08-08 |
| 1174807879 | Stephanie Lucia Natera | Social Worker | 300 Johnny Boy Ln, Berlin, NJ 08009-2705 | 2011-09-29 |
| 1043527526 | Stephanie Doss | Social Worker | 14 Village Ln, Berlin, MA 01503-1709 | 2010-09-07 |
| 1457502270 | Fran Karen Franklin | Social Worker | 15 Moonraker Rd, Berlin, MD 21811-1607 | 2008-10-10 |
| 1528248374 | Janice D. Mackenzie | Social Worker | 633 Third Ave, Berlin, NH 03570-1658 | 2007-11-09 |
| 1316068539 | Peter Adam Zerhusen | Social Worker | 6245 S Point Rd, Berlin, MD 21811-2631 | 2007-04-03 |
| 1508956327 | Judy Marie E Buteau | Social Worker | 292 Pleasant Street, Berlin, NH 03570 | 2006-10-13 |
| Find all providers in BERLIN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.