NPIMap

Organization Active NPI

Issiaih House 1

Doing business as Issaiah house 1 inc

  • Clinic/Center
  • Glen Burnie, MD
National Provider Identifier
1205460284
Registry record updated Feb 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
ISSIAIH HOUSE 1
Doing business as
Issaiah house 1 inc
Practice address
1406B Crain Hwy S Ste 201
Glen Burnie, MD 21061-4336
Phone
(443) 882-1943
NPI assigned
Feb 27, 2020
Last updated
Feb 27, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
ISSAIAH HOUSE INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 27, 2020

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

Authorized official

Name
Mr. Darryl Braxton, LCAP, LCADCNPI 1558689323
Title
Owner
Phone
(443) 882-1943

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X NU
Mental Health Counselor 101YM0800X NU

Addresses

Primary practice location

1406B Crain Hwy S Ste 201
Glen Burnie, MD 21061-4336

Mailing address

4313 Briggs Chaney Rd
Beltsville, MD 20705-1044
Phone (443) 882-1943

Other names 1

  • Issaiah house 1 inc Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Issaiah House 1 Inc3 organizations share this tax ID, including this one
Part of
Issaiah House

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the 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, 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": "1582761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582761600000",
    "number": "1205460284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4313 BRIGGS CHANEY RD",
            "city": "BELTSVILLE",
            "state": "MD",
            "postal_code": "207051044",
            "telephone_number": "443-882-1943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1406B CRAIN HWY S STE 201",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210614336",
            "telephone_number": "443-882-1943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISSIAIH HOUSE 1",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ISSAIAH HOUSE INC",
        "enumeration_date": "2020-02-27",
        "last_updated": "2020-02-27",
        "certification_date": "2020-02-27",
        "status": "A",
        "authorized_official_last_name": "BRAXTON",
        "authorized_official_first_name": "DARRYL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "443-882-1943",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCAP, LCADC"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Issaiah house 1 inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Glen Burnie, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 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.