Nicholas A Etheridge, LCPC, NCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LC11427 Issued in MD

Practice address

5500 Harford Rd Ste 201
Baltimore, MD 21214-2290

Phone

(667) 706-9091

NPI assigned

Mar 12, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Enact Counseling, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Baltimore, MD
  • NPI 1497334189
  NPD Authorized official
• B'Well Counseling Services, LLC

  • Community/Behavioral Health Agency
  • Towson, MD
  • NPI 1457849903
  NPD (past)

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

{
    "created_epoch": "1552348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621814400000",
    "number": "1003374752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 HARFORD RD STE 201",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212142290",
            "telephone_number": "667-706-9091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 HARFORD RD STE 201",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212142290",
            "telephone_number": "667-706-9091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETHERIDGE",
        "first_name": "NICHOLAS",
        "middle_name": "A",
        "credential": "LCPC, NCC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-12",
        "last_updated": "2021-05-24",
        "certification_date": "2021-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LC11427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.enactcounselingservices.com",
            "affiliation": "N",
            "endpointDescription": "professional website with contact",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5500 Harford Rd Ste 201",
            "city": "Baltimore",
            "state": "MD",
            "country_code": "US",
            "postal_code": "212142290",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Nicholas David Etchison
• Vahid Etezadi, MD
• Bridgett Etheridge-May
• Andrew Jackson Etheridge IV, CCA, CFO, CFM, CPED
• Carrie H Etheridge, LCSW-C
• Ethical Care Group LLC
• Mary-Ann Adiaha-Obong Etiebet, MD
• Etienne T. Ngoumgna
• Ashley Ettah
• Kelly Ettari

• Professional Counselor in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Professional Counselor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.