Individual provider Active NPI

John B Norris, LCPC

  • Mental Health Counselor
  • Annapolis, MD
National Provider Identifier
1154765386
Registry record updated Sep 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LC5756 Issued in MD
Practice address
2025 Harbour Gates Dr
Annapolis, MD 21401-2183
Phone
(443) 595-7973
Fax
(443) 455-1574
NPI assigned
Apr 18, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LC5756 MD Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X LCA2175 MD

Addresses

Primary practice location

2025 Harbour Gates Dr
Annapolis, MD 21401-2183

Mailing address

PO Box 6100
Annapolis, MD 21401-0100
Phone (443) 595-7973

Other identifiers 1

IdentifierTypeStateIssuer
589561800MedicaidMD

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
LCA2175MDMDAddiction (Substance Use Disorder) Counselor
LC5756MDMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Penumbra Counseling, LLC Mental Health CurrentSince Sep 20, 2020 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1366243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600041600000",
    "number": "1154765386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6100",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214010100",
            "telephone_number": "443-595-7973",
            "fax_number": "443-455-1574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2025 HARBOUR GATES DR",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214012183",
            "telephone_number": "443-595-7973",
            "fax_number": "443-455-1574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORRIS",
        "first_name": "JOHN",
        "middle_name": "B",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-18",
        "last_updated": "2020-09-14",
        "certification_date": "2020-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "LC5756",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MD",
            "license": "LCA2175",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "589561800",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Annapolis, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 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.