Organization Active NPI

NSNS Reentry Palliative Outpatient Care, LLC.

  • Addiction (Substance Use Disorder) Counselor
  • Baltimore, MD
National Provider Identifier
1083479919
Registry record updated Feb 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Legal business name
NSNS REENTRY PALLIATIVE OUTPATIENT CARE, LLC.
Practice address
2025 Maryland Ave
Baltimore, MD 21218-5918
Phone
(443) 202-3127
NPI assigned
Feb 20, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2024

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

Authorized official

Name
Janette Gonzalez-Graham, BS, GPC
Title
Director
Phone
(443) 202-3127

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X Primary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Adolescent and Children Mental Health Clinic/Center 261QM0855X
Mental Illness Community Based Residential Treatment Facility 320800000X

Addresses

Primary practice location

2025 Maryland Ave
Baltimore, MD 21218-5918

Mailing address

2025 Maryland Ave
Baltimore, MD 21218-5918
Phone (443) 202-3127

National Provider Directory

National Provider Directory

Locations

2025 Maryland Ave
Baltimore, MD 21218
Phone (443) 202-3127

Practitioners & affiliated clinicians

Practitioners 3

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": "1708387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708387200000",
    "number": "1083479919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2025 MARYLAND AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212185918",
            "telephone_number": "443-202-3127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2025 MARYLAND AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212185918",
            "telephone_number": "443-202-3127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NSNS REENTRY PALLIATIVE OUTPATIENT CARE, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-20",
        "last_updated": "2024-02-20",
        "certification_date": "2024-02-20",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ-GRAHAM",
        "authorized_official_first_name": "JANETTE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "443-202-3127",
        "authorized_official_credential": "BS, GPC"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2024; 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.