Active NPI
Essential Outcomes, LLC
- Psychologist
- Crofton, MD
National Provider Identifier
1083285928
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Psychologist | 103T00000X | Primary | ||
| Counseling Psychologist | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 317165500 | Medicaid | MD |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Psychologist
- Crofton, MD
- NPI 1508457979
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.