NPIMap

Organization Active NPI

Urban Trauma Counseling Center, LLC

  • Substance Abuse Rehabilitation Facility
  • Baltimore, MD
National Provider Identifier
1124891759
Registry record updated Nov 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
URBAN TRAUMA COUNSELING CENTER, LLC
Practice address
818 N Montford Ave
Baltimore, MD 21205-1620
Phone
(410) 844-0770
NPI assigned
Nov 6, 2023
Last updated
Nov 6, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2023

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

Authorized official

Name
Shinelle OglesbyNPI 1750865796
Title
Ceo
Phone
(410) 844-0770

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X
Substance Abuse Rehabilitation Facility 324500000X Primary

Addresses

Primary practice location

818 N Montford Ave
Baltimore, MD 21205-1620

Mailing address

3709 Essex Rd
Pikesville, MD 21207-4617
Phone (410) 960-2496

National Provider Directory

National Provider Directory
Tax ID family
Urban Trauma Counseling Center LLC10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1699228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699228800000",
    "number": "1124891759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3709 ESSEX RD",
            "city": "PIKESVILLE",
            "state": "MD",
            "postal_code": "212074617",
            "telephone_number": "410-960-2496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "818 N MONTFORD AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212051620",
            "telephone_number": "410-844-0770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "URBAN TRAUMA COUNSELING CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-06",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-06",
        "status": "A",
        "authorized_official_last_name": "OGLESBY",
        "authorized_official_first_name": "SHINELLE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "410-844-0770"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "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 Nov 6, 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.