Individual provider Active NPI

Cody John Vontran

  • Mental Health Counselor
  • Baltimore, MD
National Provider Identifier
1114402369
Registry record updated Jul 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LC13359 Issued in MD
Practice address
6802 McClean Blvd
Baltimore, MD 21234-7200
Phone
(410) 444-3800
NPI assigned
Oct 3, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2023

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 LC13359 MD Primary

Addresses

Primary practice location

6802 McClean Blvd
Baltimore, MD 21234-7200

Mailing address

6802 McClean Blvd
Baltimore, MD 21234-7200
Phone (410) 444-3800

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
LC13359MDMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1538524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690416000000",
    "number": "1114402369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6802 MCCLEAN BLVD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212347200",
            "telephone_number": "410-444-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6802 MCCLEAN BLVD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212347200",
            "telephone_number": "410-444-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VONTRAN",
        "first_name": "CODY",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-03",
        "last_updated": "2023-07-27",
        "certification_date": "2023-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "LC13359",
            "primary": true
        }
    ],
    "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 Jul 27, 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.