Active NPI
Shanita Newman
- Mental Health Counselor
- Laurel, MD
National Provider Identifier
1194300178
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 11212
- Practice address
- 10095 Washington Blvd N Apt 427
Laurel, MD 20723-1960 - Phone
- (202) 812-0606
- NPI assigned
- Mar 11, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 11212 | MD | Primary |
Addresses
Primary practice location
10095 Washington Blvd N Apt 427
Laurel, MD 20723-1960
Mailing address
10095 Washington Blvd N Apt 427
Laurel, MD 20723-1960
Phone (202) 812-0606
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
| License | State | Type | Specialty |
|---|---|---|---|
| 11212 | MD | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Myndful Therapy LLC | Current | Accepting new patients |
Interoperability endpoints
- bloomhealthcenters.shanitanewman@131200.advancedmd-direct.com
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Silver Spring, MD
- NPI 1881437580
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1615420800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1615420800000",
"number": "1194300178",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10095 WASHINGTON BLVD N APT 427",
"city": "LAUREL",
"state": "MD",
"postal_code": "207231960",
"telephone_number": "202-812-0606"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10095 WASHINGTON BLVD N APT 427",
"city": "LAUREL",
"state": "MD",
"postal_code": "207231960",
"telephone_number": "202-812-0606"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEWMAN",
"first_name": "SHANITA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-03-11",
"last_updated": "2021-03-11",
"certification_date": "2021-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MD",
"license": "11212",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Laurel, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 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.