Individual provider Active NPI

Robert Arnold Jarrett III, LCPC

  • Mental Health Counselor
  • Baltimore, MD
National Provider Identifier
1053684902
Registry record updated Aug 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LC4076 Issued in MD
Practice address
3630 Hineline Rd
Baltimore, MD 21229-5148
Phone
(443) 414-4552
NPI assigned
Feb 22, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LC4076 MD Primary

Addresses

Primary practice location

3630 Hineline Rd
Baltimore, MD 21229-5148

Mailing address

3630 Hineline Rd
Baltimore, MD 21229-5148
Phone (443) 414-4552

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250305003342 MD Practitioner - Mental Health Counselor 9931620069 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carroll County Youth Service Bureau, Inc.Group PAC ID 2365417052, 12 clinicians

Practice addresses (Care Compare)

59 Kate Wagner Rd
Westminster, MD 21157-6957
Phone (410) 848-2500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LC4076MDMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Carroll County Youth Service Bureau, Inc. CurrentSince Feb 27, 2025 Accepting new patients

Locations

59 Kate Wagner Rd
Westminster, MD 21157
Phone (410) 596-1755

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1329868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440720000000",
    "number": "1053684902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3630 HINELINE RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212295148",
            "telephone_number": "443-414-4552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3630 HINELINE RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212295148",
            "telephone_number": "443-414-4552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JARRETT",
        "first_name": "ROBERT",
        "middle_name": "ARNOLD",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-02-22",
        "last_updated": "2015-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "LC4076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.