NPIMap

Organization Active NPI

Potomac Case Management Services, Inc.

Doing business as Potomac Community Services

  • Mental Health Counselor
  • Hagerstown, MD
National Provider Identifier
1174999650
Registry record updated Jun 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
POTOMAC CASE MANAGEMENT SERVICES, INC.
Doing business as
Potomac Community Services
Practice address
324 E Antietam St Ste 104
Hagerstown, MD 21740-5754
Phone
(301) 791-3087
NPI assigned
Aug 19, 2015
Last updated
Jun 7, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2023

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

Authorized official

Name
Mrs. Dawn Renee Johns
Title
Executive Director
Phone
(301) 791-3087

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU Primary
Clinical Social Worker 1041C0700X NU

Addresses

Primary practice location

324 E Antietam St Ste 104
Hagerstown, MD 21740-5754

Mailing address

324 E Antietam St
Suite 301
Hagerstown, MD 21740-5754
Phone (301) 791-3087

Other identifiers 1

IdentifierTypeStateIssuer
880111800MedicaidMD

Other names 1

  • Potomac Community Services Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Potomac Case Management Services7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Locations

324 E Antietam St
Ste 104
Hagerstown, MD 21740
Phone (240) 707-1454

Practitioners & affiliated clinicians

Practitioners 8

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": "1439942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686096000000",
    "number": "1174999650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324 E ANTIETAM ST",
            "address_2": "SUITE 301",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217405754",
            "telephone_number": "301-791-3087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 E ANTIETAM ST STE 104",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217405754",
            "telephone_number": "301-791-3087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POTOMAC CASE MANAGEMENT SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-19",
        "last_updated": "2023-06-07",
        "certification_date": "2023-06-07",
        "status": "A",
        "authorized_official_last_name": "JOHNS",
        "authorized_official_first_name": "DAWN",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "301-791-3087",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "880111800",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Potomac Community Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hagerstown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 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.