Active NPI
East Baltimore Community Corporation / Reflective Treatment Center
- Addiction (Substance Use Disorder) Counselor
- Baltimore, MD
National Provider Identifier
1194796615
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 316811
- Legal business name
- EAST BALTIMORE COMMUNITY CORPORATION / REFLECTIVE TREATMENT CENTER
- Practice address
- 301 N Gay St
Baltimore, MD 21202-4831 - Phone
- (410) 752-3500
- Fax
- (410) 528-1005
- NPI assigned
- Feb 1, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Muriel V. Brothers
- Title
- Program Administrator
- Phone
- (410) 727-7400
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 316811 | MD | Primary |
Addresses
Primary practice location
301 N Gay St
Baltimore, MD 21202-4831
Mailing address
301 N Gay St
Baltimore, MD 21202-4813
Phone (410) 752-3500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 733530000 | Medicaid | MD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD
- Opioid treatment program
- Medicare-enrolled since Aug 7, 2020
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20201215001693 | MD | Part B Supplier - Opioid Treatment Program (Otp) | 0345652475 | Practice locations: Baltimore, MD |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 21D2056504 | Reflective Treatment Center | Certificate of waiver | Mar 27, 2027 |
National Provider Directory
National Provider DirectoryLocations
301 N Gay St
Baltimore, MD 21202
Phone (410) 752-3500
301 N Gay St
Lowr
Baltimore, MD 21202
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Addiction Medicine (Family Medicine) Physician
- Oxford, NC
- NPI 1073753497
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138752000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1426723200000",
"number": "1194796615",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "301 N GAY ST",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212024813",
"telephone_number": "410-752-3500",
"fax_number": "410-528-1005"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 N GAY ST",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212024831",
"telephone_number": "410-752-3500",
"fax_number": "410-528-1005"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EAST BALTIMORE COMMUNITY CORPORATION / REFLECTIVE TREATMENT CENTER",
"organizational_subpart": "NO",
"enumeration_date": "2006-02-01",
"last_updated": "2015-03-19",
"status": "A",
"authorized_official_last_name": "BROTHERS",
"authorized_official_first_name": "MURIEL",
"authorized_official_middle_name": "V.",
"authorized_official_title_or_position": "PROGRAM ADMINISTRATOR",
"authorized_official_telephone_number": "410-727-7400",
"authorized_official_name_prefix": "Ms."
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "MD",
"license": "316811",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "733530000",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.