Individual provider Active NPI

Leila Fazeli

  • Mental Health Counselor
  • Lutherville Timonium, MD
National Provider Identifier
1114383395
Registry record updated Jan 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LGP6760 Issued in MD
Practice address
9475 Deereco Rd
Suite 410 Core Counseling
Lutherville Timonium, MD 21093-2118
Phone
(301) 305-9174
NPI assigned
Jan 4, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 4, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LGP6760 MD Primary

Addresses

Primary practice location

9475 Deereco Rd
Suite 410 Core Counseling
Lutherville Timonium, MD 21093-2118

Mailing address

76 Cranbrook Rd Unit 291
Cockeysville, MD 21030-3404

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LGP6760MDMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1451865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451865600000",
    "number": "1114383395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "76 CRANBROOK RD UNIT 291",
            "city": "COCKEYSVILLE",
            "state": "MD",
            "postal_code": "210303404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9475 DEERECO RD",
            "address_2": "SUITE 410 CORE COUNSELING",
            "city": "LUTHERVILLE TIMONIUM",
            "state": "MD",
            "postal_code": "210932118",
            "telephone_number": "301-305-9174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAZELI",
        "first_name": "LEILA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-01-04",
        "last_updated": "2016-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "LGP6760",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lutherville Timonium, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2016; 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.