Kolmac Clinic, LLC

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

License

BH000038 Issued in MD

Legal business name

KOLMAC CLINIC, LLC

Doing business as

Kolmac Outpatient Recovery Centers

Practice address

8561 Fenton St Ste 250
Silver Spring, MD 20910-4483

Phone

(301) 589-0255

Fax

(301) 589-0291

NPI assigned

Jul 28, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Michael J Clark

Title

Director of Operations

Phone

(301) 589-0255

Specialties & licenses 1

Addresses

Other names 1

• Kolmac Outpatient Recovery Centers Doing business as

Tax ID family

Kolmac Clinic4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

• Kolmac Clinic LLC

  dba Kolmac Outpatient Recovery Centers

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Burtonsville, MD
  • NPI 1215557038
  NPD tax ID
• Kolmac Clinic, LLC

  dba Kolmac Outpatient Recovery Centers

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Towson, MD
  • NPI 1275155335
  NPD tax ID
• Kolmac Clinic, LLC

  dba Kolmac Outpatient Recovery Centers

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Arlington, VA
  • NPI 1346862562
  NPD tax ID

Locations

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Kolmac Clinic LLC

  dba Kolmac Outpatient Recovery Centers

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Burtonsville, MD
  • NPI 1215557038
  NPPES parent name
• Kolmac Clinic, LLC

  dba Kolmac Outpatient Recovery Centers

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Towson, MD
  • NPI 1275155335
  NPPES parent name

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Elaine Sullivan Altmire, LPC

  • Professional Counselor
  • Arlington, VA
  • NPI 1518592112
  NPD (past)
• Anna Kaspark, LMSW LCSW-C LICSW

  • Clinical Social Worker
  • Washington, DC
  • NPI 1710358874
  NPD (past)
• George Kolodner, MD

  • Psychiatry Physician
  • Washington, DC
  • NPI 1255330411
  NPD (past)

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626998400000",
    "number": "1184638512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3919 NATIONAL DR STE 300",
            "city": "BURTONSVILLE",
            "state": "MD",
            "postal_code": "208661180",
            "telephone_number": "301-589-0255",
            "fax_number": "301-589-0291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8561 FENTON ST STE 250",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209104483",
            "telephone_number": "301-589-0255",
            "fax_number": "301-589-0291"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15800 Gaither Dr Ste 210",
            "address_purpose": "LOCATION",
            "city": "Gaithersburg",
            "state": "MD",
            "postal_code": "208771432",
            "country_code": "US",
            "telephone_number": "301-589-0255",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6525 N Charles St Ste 85",
            "address_purpose": "LOCATION",
            "city": "Towson",
            "state": "MD",
            "postal_code": "212046872",
            "country_code": "US",
            "telephone_number": "301-589-0255",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "820 Bestgate Rd Ste 2C",
            "address_purpose": "LOCATION",
            "city": "Annapolis",
            "state": "MD",
            "postal_code": "214013404",
            "country_code": "US",
            "telephone_number": "301-589-0255",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 N Charles St Ste 602",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212013732",
            "country_code": "US",
            "telephone_number": "301-589-0255",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1701 Clarendon Blvd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Arlington",
            "state": "VA",
            "postal_code": "222092700",
            "country_code": "US",
            "telephone_number": "301-589-0255",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4221 Forbes Blvd Ste 120",
            "address_purpose": "LOCATION",
            "city": "Lanham",
            "state": "MD",
            "postal_code": "207064343",
            "country_code": "US",
            "telephone_number": "301-589-0255",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5301 Buckeystown Pike Ste 215",
            "address_purpose": "LOCATION",
            "city": "Frederick",
            "state": "MD",
            "postal_code": "217048365",
            "country_code": "US",
            "telephone_number": "301-589-0255",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10632 Little Patuxent Pkwy Ste 410",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "MD",
            "postal_code": "210443252",
            "country_code": "US",
            "telephone_number": "301-589-0255",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 Delaware Ave Ste 2232",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "DE",
            "postal_code": "198011607",
            "country_code": "US",
            "telephone_number": "301-589-0255",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "301 Oxford Valley Rd Ste 1402",
            "address_purpose": "LOCATION",
            "city": "Yardley",
            "state": "PA",
            "postal_code": "190677706",
            "country_code": "US",
            "telephone_number": "301-589-0255",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1411 K St NW Ste 703",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200053404",
            "country_code": "US",
            "telephone_number": "301-589-0255",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KOLMAC CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-28",
        "last_updated": "2021-07-23",
        "certification_date": "2021-07-23",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "301-589-0255",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "MD",
            "license": "BH000038",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kolmac Outpatient Recovery Centers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amy Kohn McNelly, LCMFT, LMFT, CAC-II
• David Kohn, CRNP-PMH
• Philip Koi, MD
• Assemien Martial Kokora
• Elizabeth Ann Koller, M.D.
• Christine Edith Kom Fotso, HHA
• Aicha Konate, HHA
• Edwige Kondombo, PHARMACIST
• Djeneba Kone
• Hawa Kone

• Substance Use Disorder Rehabilitation Clinic/Center in Silver Spring, MD
• Providers in Silver Spring, MD by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2021; 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.