Active NPI
Thomas J Conway, ADT
- Addiction (Substance Use Disorder) Counselor
- Baltimore, MD
National Provider Identifier
1043884554
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 1712
- Practice address
- 112 E Patapsco Ave
Baltimore, MD 21225-1745 - Phone
- (667) 260-2640
- NPI assigned
- May 19, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 1712 | MD | Primary |
Addresses
Primary practice location
112 E Patapsco Ave
Baltimore, MD 21225-1745
Mailing address
1115 Leonard Dr
Glen Burnie, MD 21060-8236
Phone (443) 875-1718
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1712 | MD | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1621382400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1621382400000",
"number": "1043884554",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1115 LEONARD DR",
"city": "GLEN BURNIE",
"state": "MD",
"postal_code": "210608236",
"telephone_number": "443-875-1718"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "112 E PATAPSCO AVE",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212251745",
"telephone_number": "667-260-2640"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONWAY",
"first_name": "THOMAS",
"middle_name": "J",
"credential": "ADT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-05-19",
"last_updated": "2021-05-19",
"certification_date": "2021-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "MD",
"license": "1712",
"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 19, 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.