Individual provider Active NPI

Bobby Vann Jr., LGPC

  • Mental Health Counselor
  • Towson, MD
National Provider Identifier
1114476884
Registry record updated Sep 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LGP7337 Issued in MD
Practice address
8415 Bellona LN
Suite 215
Towson, MD 21204-2055
Phone
(410) 245-2611
NPI assigned
Sep 23, 2016
Last updated
Sep 23, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 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 LGP7337 MD Primary

Addresses

Primary practice location

8415 Bellona LN
Suite 215
Towson, MD 21204-2055

Mailing address

8415 Bellona LN
Suite 215
Towson, MD 21204-2055
Phone (410) 245-2611

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
LGP7337MDMDMental Health Counselor

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1474588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474588800000",
    "number": "1114476884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8415 BELLONA LN",
            "address_2": "SUITE 215",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212042055",
            "telephone_number": "410-245-2611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8415 BELLONA LN",
            "address_2": "SUITE 215",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212042055",
            "telephone_number": "410-245-2611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANN",
        "first_name": "BOBBY",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "LGPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-09-23",
        "last_updated": "2016-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "LGP7337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Towson, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 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.