Integrated Counseling Professionals LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

INTEGRATED COUNSELING PROFESSIONALS LLC

Doing business as

Integrated Counseling Professionals LLC

Practice address

1614 E. Churchville Rd
Ste 101a
Bel Air, MD 21015-2050

Phone

(443) 372-8573

NPI assigned

Dec 17, 2018

Last updated

Dec 17, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Earnest Russell Reaves, LCPCNPI 1164936738

Title

Managing Member / Clinician

Phone

(443) 691-4982

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Integrated Counseling Professionals LLC Doing business as

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Locations

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.

• Earnest Russell Reaves, LCPC

  • Professional Counselor
  • Edgewood, MD
  • NPI 1164936738
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1545004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1545004800000",
    "number": "1245701119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1614 E. CHURCHVILLE RD",
            "address_2": "STE 101A",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210152050",
            "telephone_number": "443-372-8573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1614 E. CHURCHVILLE RD",
            "address_2": "STE 101A",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210152050",
            "telephone_number": "443-372-8573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED COUNSELING PROFESSIONALS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-17",
        "last_updated": "2018-12-17",
        "status": "A",
        "authorized_official_last_name": "REAVES",
        "authorized_official_first_name": "EARNEST",
        "authorized_official_middle_name": "RUSSELL",
        "authorized_official_title_or_position": "MANAGING MEMBER / CLINICIAN",
        "authorized_official_telephone_number": "443-691-4982",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INSURERS",
            "identifier": "1164936738",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Integrated Counseling Professionals LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Professional Counselor in Bel Air, MD
• Providers in Bel Air, MD by specialty
• Professional Counselor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.