NPIMap

Organization Active NPI

Survivor Sources Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Hyattsville, MD
National Provider Identifier
1174160980
Registry record updated Nov 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
SURVIVOR SOURCES INC
Practice address
4301 Garden City Dr Ste 304
Hyattsville, MD 20785-6105
Phone
(301) 235-0060
NPI assigned
Nov 30, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2020

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

Authorized official

Name
Dr. Marshalee GeorgeNPI 1952370272
Title
Chairman
Phone
(443) 453-3343

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care CoordinatorGroup: 193200000X MULTI-SPECIALTY GROUP 171M00000X
Developmentally Disabled Services Day Training Agency 251C00000X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X
Obstetrics & Gynecology Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LX0001X

Addresses

Primary practice location

4301 Garden City Dr Ste 304
Hyattsville, MD 20785-6105

Mailing address

4301 Garden City Dr Ste 304
Hyattsville, MD 20785-6105
Phone (301) 235-0060

National Provider Directory

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.

NPI Registry JSON

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

{
    "created_epoch": "1575072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605225600000",
    "number": "1174160980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 GARDEN CITY DR STE 304",
            "city": "HYATTSVILLE",
            "state": "MD",
            "postal_code": "207856105",
            "telephone_number": "301-235-0060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 GARDEN CITY DR STE 304",
            "city": "HYATTSVILLE",
            "state": "MD",
            "postal_code": "207856105",
            "telephone_number": "301-235-0060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURVIVOR SOURCES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-30",
        "last_updated": "2020-11-13",
        "certification_date": "2020-11-13",
        "status": "A",
        "authorized_official_last_name": "GEORGE",
        "authorized_official_first_name": "MARSHALEE",
        "authorized_official_title_or_position": "CHAIRMAN",
        "authorized_official_telephone_number": "443-453-3343",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LX0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hyattsville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 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.