Active NPI
Omar Sillah, CRC
- Counselor
- Laurel, MD
National Provider Identifier
1215375282
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 00117360
- Practice address
- 11738 S Laurel Dr
Apt 4a
Laurel, MD 20708-2940 - Phone
- (202) 499-0885
- NPI assigned
- Jun 11, 2013
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | 00117360 | IL | Primary |
Addresses
Primary practice location
11738 S Laurel Dr
Apt 4a
Laurel, MD 20708-2940
Mailing address
11738 S Laurel Dr
Apt 4a
Laurel, MD 20708-2940
Phone (202) 499-0885
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 |
|---|---|---|---|
| 00117360 | IL | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Odyssey Education Academy Inc | Past | Accepting new patients |
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.
-
- Community/Behavioral Health Agency
- Laurel, MD
- NPI 1841630456
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1370908800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1370908800000",
"number": "1215375282",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11738 S LAUREL DR",
"address_2": "APT 4A",
"city": "LAUREL",
"state": "MD",
"postal_code": "207082940",
"telephone_number": "202-499-0885"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11738 S LAUREL DR",
"address_2": "APT 4A",
"city": "LAUREL",
"state": "MD",
"postal_code": "207082940",
"telephone_number": "202-499-0885"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SILLAH",
"first_name": "OMAR",
"name_prefix": "Mr.",
"credential": "CRC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-06-11",
"last_updated": "2013-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "IL",
"license": "00117360",
"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 Jun 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.