NPIMap

Organization Active NPI

Initiating Change Through Social Development, Inc.

  • Community/Behavioral Health Agency
  • Baltimore, MD
National Provider Identifier
1013363530
Registry record updated May 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
INITIATING CHANGE THROUGH SOCIAL DEVELOPMENT, INC.
Practice address
8 Pea Pod CT
Baltimore, MD 21207-4201
Phone
(443) 682-3986
NPI assigned
May 13, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2016

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

Authorized official

Name
Dearndra Hendricks
Title
Founder and Executive Director
Phone
(443) 682-3986

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X
Developmentally Disabled Services Day Training Agency 251C00000X
Community/Behavioral Health Agency 251S00000X MD Primary

Addresses

Primary practice location

8 Pea Pod CT
Baltimore, MD 21207-4201

Mailing address

8 Pea Pod CT
Baltimore, MD 21207-4201
Phone (443) 682-3986

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1463097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463097600000",
    "number": "1013363530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 PEA POD CT",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212074201",
            "telephone_number": "443-682-3986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 PEA POD CT",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212074201",
            "telephone_number": "443-682-3986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INITIATING CHANGE THROUGH SOCIAL DEVELOPMENT, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-13",
        "last_updated": "2016-05-13",
        "status": "A",
        "authorized_official_last_name": "HENDRICKS",
        "authorized_official_first_name": "DEARNDRA",
        "authorized_official_title_or_position": "FOUNDER AND EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "443-682-3986"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2016; 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.