NPIMap

Organization Active NPI

Nicole Rudd, LCPC

  • Mental Health Counselor
  • Bowie, MD
National Provider Identifier
1053906685
Registry record updated Mar 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
NICOLE RUDD, LCPC
Practice address
2905 Mitchellville Rd Ste 112
Bowie, MD 20716-1321
Phone
(202) 406-0929
NPI assigned
Mar 5, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2021

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

Authorized official

Name
Nicole Rudd, LCPCNPI 1427528819
Title
Owner
Phone
(202) 406-0929

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

2905 Mitchellville Rd Ste 112
Bowie, MD 20716-1321

Mailing address

2905 Mitchellville Rd Ste 112
Bowie, MD 20716-1321
Phone (202) 406-0929

National Provider Directory

National Provider Directory

Locations

2905 Mitchellville Rd
Ste 112
Bowie, MD 20716
Phone (202) 406-0929

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1614902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614902400000",
    "number": "1053906685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2905 MITCHELLVILLE RD STE 112",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207161321",
            "telephone_number": "202-406-0929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2905 MITCHELLVILLE RD STE 112",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207161321",
            "telephone_number": "202-406-0929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NICOLE RUDD, LCPC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-05",
        "last_updated": "2021-03-05",
        "certification_date": "2021-02-11",
        "status": "A",
        "authorized_official_last_name": "RUDD",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "202-406-0929",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowie, MD

Sources for this page

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