RBG Wellness Space, LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

RBG WELLNESS SPACE, LLC

Practice address

1206 Lakeside Ave
Baltimore, MD 21218-3001

Phone

(847) 770-7477

NPI assigned

Feb 1, 2021

Last updated

Apr 5, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Aisha Jean-Baptiste, LCSW-CNPI 1942694799

Title

Licensed Clinical Social Worker

Phone

(847) 770-7477

Specialties & licenses 2

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Aisha Jean-Baptiste, LCSW-C

  • Clinical Social Worker
  • Baltimore, MD
  • NPI 1942694799
  NPD Authorized official

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

{
    "created_epoch": "1612137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617580800000",
    "number": "1023609179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1206 LAKESIDE AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212183001",
            "telephone_number": "847-770-7477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1206 LAKESIDE AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212183001",
            "telephone_number": "847-770-7477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RBG WELLNESS SPACE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-01",
        "last_updated": "2021-04-05",
        "certification_date": "2021-04-05",
        "status": "A",
        "authorized_official_last_name": "JEAN-BAPTISTE",
        "authorized_official_first_name": "AISHA",
        "authorized_official_title_or_position": "LICENSED CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "847-770-7477",
        "authorized_official_credential": "LCSW-C"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Muzammil Razvi
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• RCK, LLC
• Re Physical Therapy and Wellness LLC

• Mental Health Counselor in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Mental Health Counselor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 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.