Performance Complex

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

09146 Issued in MD

Legal business name

PERFORMANCE COMPLEX

Practice address

402 W Pennsylvania Avenue
Towson, MD 21204

Phone

(410) 298-8223

Fax

(410) 298-8225

NPI assigned

May 14, 2007

Organization subpart

No

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

Authorized official

Name

Louise Macy

Title

Billing MGR

Phone

(410) 298-8223

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1144436742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14221 DOVE CREEK WAY UNIT 304",
            "city": "SPARKS",
            "state": "MD",
            "postal_code": "211528814",
            "telephone_number": "410-771-4397",
            "fax_number": "410-298-8225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 W PENNSYLVANIA AVENUE",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "21204",
            "telephone_number": "410-298-8223",
            "fax_number": "410-298-8225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERFORMANCE COMPLEX",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MACY",
        "authorized_official_first_name": "LOUISE",
        "authorized_official_title_or_position": "BILLING MGR",
        "authorized_official_telephone_number": "410-298-8223"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "09146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Towson, MD
• Providers in Towson, MD by specialty
• Professional Counselor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.