NPIMap

Organization Active NPI

Restore You Counseling and Consultation, LLC

  • Mental Health Counselor
  • Baltimore, MD
National Provider Identifier
1235795733
Registry record updated Jun 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
RESTORE YOU COUNSELING AND CONSULTATION, LLC
Practice address
6401 Pioneer Dr
Baltimore, MD 21214-1092
Phone
(410) 564-6893
NPI assigned
May 10, 2019
Last updated
Jun 11, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2019

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

Authorized official

Name
Channing ClarkNPI 1306388293
Title
Ceo, Owner
Phone
(301) 254-9608

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

6401 Pioneer Dr
Baltimore, MD 21214-1092

Mailing address

4812 Circling Hunter Dr Apt 202
Columbia, MD 21045-5508

Other identifiers 1

IdentifierTypeStateIssuer
2011131MedicaidMD

National Provider Directory

National Provider Directory
Tax ID family
Restore You Counseling and Consultation LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

6401 Pioneer Dr
Baltimore, MD 21214
Phone (410) 545-1746

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": "1557446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560211200000",
    "number": "1235795733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4812 CIRCLING HUNTER DR APT 202",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210455508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6401 PIONEER DR",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212141092",
            "telephone_number": "410-564-6893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESTORE YOU COUNSELING AND CONSULTATION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-10",
        "last_updated": "2019-06-11",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "CHANNING",
        "authorized_official_title_or_position": "CEO, OWNER",
        "authorized_official_telephone_number": "301-254-9608"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2011131",
            "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 Jun 11, 2019; 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.