NPIMap

Organization Active NPI

Corsica Family Therapy, LLC

  • Clinical Social Worker
  • Centreville, MD
National Provider Identifier
1033409289
Registry record updated Apr 8, 2011
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Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
13638 Issued in MD
Legal business name
CORSICA FAMILY THERAPY, LLC
Practice address
205 E Water St
Suite C
Centreville, MD 21617-1155
Phone
(410) 490-9742
NPI assigned
Apr 8, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2011

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

Authorized official

Name
Mrs. Rebecca Ann Cook, LCSW-C
Title
President/ Clinical Director
Phone
(410) 490-9742

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 13638 MD Primary

Addresses

Primary practice location

205 E Water St
Suite C
Centreville, MD 21617-1155

Mailing address

PO Box 511
Centreville, MD 21617-0511
Phone (410) 490-9742

National Provider Directory

National Provider Directory

Locations

205 E Water St
Ste C
Centreville, MD 21617
Phone (410) 490-7357

NPI Registry JSON

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

{
    "created_epoch": "1302220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302220800000",
    "number": "1033409289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 511",
            "city": "CENTREVILLE",
            "state": "MD",
            "postal_code": "216170511",
            "telephone_number": "410-490-9742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 E WATER ST",
            "address_2": "SUITE C",
            "city": "CENTREVILLE",
            "state": "MD",
            "postal_code": "216171155",
            "telephone_number": "410-490-9742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORSICA FAMILY THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-08",
        "last_updated": "2011-04-08",
        "status": "A",
        "authorized_official_last_name": "COOK",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PRESIDENT/ CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "410-490-9742",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW-C"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "13638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centreville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2011; 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.