CC Behavioral Health LTD

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

CC BEHAVIORAL HEALTH LTD

Practice address

2324 W Joppa Rd Ste 130
Lutherville, MD 21093

Phone

(773) 540-7274

NPI assigned

Jan 15, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Coralie Castro, PSY.D., LCPC

Title

President

Phone

(773) 540-7274

Specialties & licenses 2

Addresses

Other names 1

• CC Behavioral Health LTD Doing business as

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

{
    "created_epoch": "1547510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1547510400000",
    "number": "1114491834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2324 W JOPPA RD STE 130",
            "city": "LUTHERVILLE",
            "state": "MD",
            "postal_code": "210934615",
            "telephone_number": "773-540-7274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2324 W JOPPA RD STE 130",
            "city": "LUTHERVILLE",
            "state": "MD",
            "postal_code": "21093",
            "telephone_number": "773-540-7274"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2324 W Joppa Rd Ste 130",
            "address_purpose": "LOCATION",
            "city": "Lutherville",
            "state": "MD",
            "postal_code": "21093",
            "country_code": "US",
            "telephone_number": "773-540-7274",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CC BEHAVIORAL HEALTH LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-15",
        "last_updated": "2019-01-15",
        "status": "A",
        "authorized_official_last_name": "CASTRO",
        "authorized_official_first_name": "CORALIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-540-7274",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D., LCPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CC Behavioral Health LTD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2019; 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.