NPIMap

Organization Active NPI

Uncaged Potential

  • Adult Mental Health Clinic/Center
  • Towson, MD
National Provider Identifier
1205469475
Registry record updated Apr 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
UNCAGED POTENTIAL
Practice address
1 Olympic PL Ste 900
Towson, MD 21204-4113
Phone
(201) 920-6787
NPI assigned
Feb 17, 2020
Last updated
Apr 2, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2024

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

Authorized official

Name
Jeffrey AvilesNPI 1659726834
Title
Therapist
Phone
(201) 920-6787

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X Primary

Addresses

Primary practice location

1 Olympic PL Ste 900
Towson, MD 21204-4113

Mailing address

703 Dale Ave
Baltimore, MD 21206-1308
Phone (201) 920-6787

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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": "1581897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712016000000",
    "number": "1205469475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 DALE AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212061308",
            "telephone_number": "201-920-6787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 OLYMPIC PL STE 900",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212044113",
            "telephone_number": "201-920-6787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNCAGED POTENTIAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-17",
        "last_updated": "2024-04-02",
        "certification_date": "2024-04-02",
        "status": "A",
        "authorized_official_last_name": "AVILES",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "THERAPIST",
        "authorized_official_telephone_number": "201-920-6787"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Towson, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2024; 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.