NPIMap

Organization Active NPI

Away of Change Counseling Service, LLC

  • Mental Health Counselor
  • Baltimore, MD
National Provider Identifier
1235623968
Registry record updated Mar 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LCA2042 Issued in MD
Legal business name
AWAY OF CHANGE COUNSELING SERVICE, LLC
Doing business as
Away of Change Counseling Service
Practice address
6609 Reisterstown Rd Ste 206
Baltimore, MD 21215-2315
Phone
(443) 405-3193
Fax
(443) 272-7572
NPI assigned
Jun 16, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2021

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

Authorized official

Name
Ms. Doris Allen, MED, M.S., LCADCNPI 1699183335
Title
Founder and Ceo
Phone
(443) 922-8928

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
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X LCA2042 MD Primary

Addresses

Primary practice location

6609 Reisterstown Rd Ste 206
Baltimore, MD 21215-2315

Mailing address

5310 Old Court Rd Ste 304
Randallstown, MD 21133-6202
Phone (443) 405-3193

Other names 1

  • Away of Change Counseling Service Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Away of Change Counseling Service7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1529107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616025600000",
    "number": "1235623968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5310 OLD COURT RD STE 304",
            "city": "RANDALLSTOWN",
            "state": "MD",
            "postal_code": "211336202",
            "telephone_number": "443-405-3193",
            "fax_number": "443-272-7572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6609 REISTERSTOWN RD STE 206",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212152315",
            "telephone_number": "443-405-3193",
            "fax_number": "443-272-7572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AWAY OF CHANGE COUNSELING SERVICE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-16",
        "last_updated": "2021-03-18",
        "certification_date": "2021-02-16",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "DORIS",
        "authorized_official_title_or_position": "FOUNDER AND CEO",
        "authorized_official_telephone_number": "443-922-8928",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MED, M.S., LCADC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "LCA2042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Away of Change Counseling Service",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 18, 2021; 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.