Organization Active NPI

Essential Outcomes, LLC

  • Psychologist
  • Crofton, MD
National Provider Identifier
1083285928
Registry record updated Jan 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
ESSENTIAL OUTCOMES, LLC
Practice address
2138 Priest Bridge CT Ste 1
Crofton, MD 21114-2463
Phone
(443) 274-6000
NPI assigned
Jul 1, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2023

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

Authorized official

Name
Mr. Clifford Eugene Sheppard
Title
Co-Owner
Phone
(443) 584-6773

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X Primary
Counseling PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC1900X

Addresses

Primary practice location

2138 Priest Bridge CT Ste 1
Crofton, MD 21114-2463

Mailing address

1123 State Route 3 N # 300
Gambrills, MD 21054-1715
Phone (443) 584-6773

Other identifiers 1

IdentifierTypeStateIssuer
317165500MedicaidMD

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1625097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673395200000",
    "number": "1083285928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1123 STATE ROUTE 3 N # 300",
            "city": "GAMBRILLS",
            "state": "MD",
            "postal_code": "210541715",
            "telephone_number": "443-584-6773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2138 PRIEST BRIDGE CT STE 1",
            "city": "CROFTON",
            "state": "MD",
            "postal_code": "211142463",
            "telephone_number": "443-274-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ESSENTIAL OUTCOMES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-01",
        "last_updated": "2023-01-11",
        "certification_date": "2023-01-11",
        "status": "A",
        "authorized_official_last_name": "SHEPPARD",
        "authorized_official_first_name": "CLIFFORD",
        "authorized_official_middle_name": "EUGENE",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "443-584-6773",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "317165500",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Crofton, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2023; 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.