NPIMap

Organization Active NPI

Clinical Service Connections, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Columbia, MD
National Provider Identifier
1073901278
Registry record updated Dec 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
1522 Issued in MD
Legal business name
CLINICAL SERVICE CONNECTIONS, INC
Practice address
8930 Route 108
Suite a
Columbia, MD 21045-2121
Phone
(443) 661-1301
Fax
(443) 661-1175
NPI assigned
Dec 23, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2014

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

Authorized official

Name
Mr. Edwin Richard Butler III
Title
Vice President
Phone
(443) 661-1301

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 1522 MD Primary

Addresses

Primary practice location

8930 Route 108
Suite a
Columbia, MD 21045-2121

Mailing address

8930 Route 108
Suite a
Columbia, MD 21045-2121
Phone (443) 661-1301

National Provider Directory

National Provider Directory

Locations

8930 Route 108
Ste A
Columbia, MD 21045
Phone (443) 661-1301

NPI Registry JSON

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

{
    "created_epoch": "1419292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419292800000",
    "number": "1073901278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8930 ROUTE 108",
            "address_2": "SUITE A",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210452121",
            "telephone_number": "443-661-1301",
            "fax_number": "443-661-1175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8930 ROUTE 108",
            "address_2": "SUITE A",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210452121",
            "telephone_number": "443-661-1301",
            "fax_number": "443-661-1175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICAL SERVICE CONNECTIONS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-23",
        "last_updated": "2014-12-23",
        "status": "A",
        "authorized_official_last_name": "BUTLER",
        "authorized_official_first_name": "EDWIN",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "443-661-1301",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "MD",
            "license": "1522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2014; 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.