NPIMap

Organization Active NPI

Family Health Center

  • Group Psychotherapy Psychologist
  • Gaithersburg, MD
National Provider Identifier
1093750697
Registry record updated Dec 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Group Psychotherapy PsychologistTaxonomy code 103TP2701X
License
LC0295 Issued in MD
Legal business name
FAMILY HEALTH CENTER
Practice address
6 Montgomery Village Ave
400
Gaithersburg, MD 20879-3546
Phone
(301) 963-7222
Fax
(301) 963-2616
NPI assigned
Jun 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2020

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

Authorized official

Name
Dr. Bruke Tadesse
Title
Executive Director
Phone
(301) 779-2461

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Addiction (Substance Use Disorder) PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TA0400X
Group Psychotherapy PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TP2701X LC0295 MD Primary
Adult Mental Health Clinic/Center 261QM0850X

Addresses

Primary practice location

6 Montgomery Village Ave
400
Gaithersburg, MD 20879-3546

Mailing address

6 Montgomery Village Ave
400
Gaithersburg, MD 20879-3546
Phone (301) 963-7222

National Provider Directory

National Provider Directory
Tax ID family
Family Health Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

6 Montgomery Village Ave
Ste 400
Gaithersburg, MD 20879
Phone (301) 963-7222

Practitioners & affiliated clinicians

Practitioners 1

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

  • Alvaro W Jaya
    • Addiction (Substance Use Disorder) Counselor
    • Gaithersburg, MD
    • NPI 1598228827
    NPD

NPI Registry JSON

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

{
    "created_epoch": "1150588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607299200000",
    "number": "1093750697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 MONTGOMERY VILLAGE AVE",
            "address_2": "400",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208793546",
            "telephone_number": "301-963-7222",
            "fax_number": "301-963-2616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 MONTGOMERY VILLAGE AVE",
            "address_2": "400",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208793546",
            "telephone_number": "301-963-7222",
            "fax_number": "301-963-2616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-18",
        "last_updated": "2020-12-07",
        "certification_date": "2020-12-07",
        "status": "A",
        "authorized_official_last_name": "TADESSE",
        "authorized_official_first_name": "BRUKE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "301-779-2461",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "MD",
            "license": "LC0295",
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gaithersburg, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2020; 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.