NPIMap

Organization Active NPI

Emotional Wellness Counseling

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Baltimore, MD
National Provider Identifier
1235406265
Registry record updated Nov 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
LC3272 Issued in MD
Legal business name
EMOTIONAL WELLNESS COUNSELING
Practice address
8508 Loch Raven Blvd
Suite I
Baltimore, MD 21286-2354
Phone
(443) 895-4183
Fax
(443) 895-4184
NPI assigned
Nov 18, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2011

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

Authorized official

Name
Dr. Adeline McTavous, MARYLAND 8/1/11
Title
Owner
Phone
(443) 895-4183

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X LC3272 MD Primary

Addresses

Primary practice location

8508 Loch Raven Blvd
Suite I
Baltimore, MD 21286-2354

Mailing address

8508 Loch Raven Blvd
Suite I
Baltimore, MD 21286-2354
Phone (443) 895-4183

Other identifiers 1

IdentifierTypeStateIssuer
419542600MedicaidMD

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1321574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321574400000",
    "number": "1235406265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8508 LOCH RAVEN BLVD",
            "address_2": "SUITE I",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212862354",
            "telephone_number": "443-895-4183",
            "fax_number": "443-895-4184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8508 LOCH RAVEN BLVD",
            "address_2": "SUITE I",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212862354",
            "telephone_number": "443-895-4183",
            "fax_number": "443-895-4184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMOTIONAL WELLNESS COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-18",
        "last_updated": "2011-11-18",
        "status": "A",
        "authorized_official_last_name": "MCTAVOUS",
        "authorized_official_first_name": "ADELINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "443-895-4183",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MARYLAND 8/1/11"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "MD",
            "license": "LC3272",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "419542600",
            "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 Nov 18, 2011; 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.