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KHADEJAH MCDOUGALD LCSW-C
NPI 1689345993
Social Worker in Baltimore, MD

Active since September 26, 2021PECOS EnrolledAccepts Medicare Assignment
4200 EDMONDSON AVE STE 202A, BALTIMORE, MD 21229(667) 205-1646 Get Directions Write a Review

NPPES record last updated: March 8, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Mar 8, 2023, Sep 26, 2021 (2 updates tracked since 2021).

About Khadejah Mcdougald Lcsw-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KHADEJAH MCDOUGALD LCSW-C (NPI 1689345993) is an individual social worker in Baltimore, Maryland, licensed in Maryland (23645) and active in the NPI registry since September 2021. She is enrolled in Medicare PECOS and is a graduate of Other (2010).

NPPES Registry Identity

NPI1689345993
Entity TypeIndividualFemale
Primary Taxonomy104100000X
Provider Legal NameKHADEJAH MCDOUGALDCredential: LCSW-C
Location Address4200 EDMONDSON AVE STE 202ABaltimore, MD 21229-1614
Mailing Address1407 Harberson RdCatonsville, MD 21228-1117 · (443) 422-5095
Phone(667) 205-1646
Sole ProprietorYes
Medical School CMSOtherGraduated 2010
Enumeration DateSeptember 26, 2021
Last NPPES UpdateMarch 8, 20232 updates tracked since enumeration
NPPES CertifiedMarch 8, 2023
✔ NPI 1689345993 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial WorkerBehavioral Health & Social Service Providers
Taxonomy Code104100000X
License✔ Licensed in MD · 23645
Definition
A social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public.
4200 EDMONDSON AVE STE 202A, Baltimore, MD 21229
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Khadejah Mcdougald Lcsw-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8224478482
PECOS Enrollment IDI20240926003591
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Khadejah Mcdougald reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Integrated Life Therapeutic Solutions
0.3 mi
Clinical
4024 COLBORNE RD
Baltimore, MD 21229
  • Reassigned Medicare billing, Maryland enrollment
  • 2 clinicians in this Medicare group
NPI 1396423240 (443) 422-5095

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Khadejah Mcdougald's NPI number?

The NPI number for Khadejah Mcdougald is 1689345993. It was assigned to this individual provider in the NPPES registry on September 26, 2021.

Where is Khadejah Mcdougald located?

Khadejah Mcdougald practices at 4200 Edmondson Ave Ste 202A, Baltimore, MD 21229. The listed phone number is (667) 205-1646.

What is Khadejah Mcdougald's specialty?

The primary specialty registered for this NPI is Social Worker with taxonomy code 104100000X.

Is Khadejah Mcdougald enrolled in Medicare?

Yes. Khadejah Mcdougald is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Khadejah Mcdougald's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Khadejah Mcdougald reassigns Medicare benefits to Integrated Life Therapeutic Solutions (Baltimore, MD). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Khadejah Mcdougald's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Khadejah Mcdougald was last updated on March 8, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.