Organization Active NPI

Convergent Mental Health and Wellness, LLC

  • Clinical Social Worker
  • Cockeysville, MD
National Provider Identifier
1265117790
Registry record updated Aug 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
CONVERGENT MENTAL HEALTH AND WELLNESS, LLC
Practice address
213 Old Padonia Rd
Cockeysville, MD 21030-4935
Phone
(443) 840-8994
NPI assigned
Jun 21, 2023
Organization subpart
Yes
Parent organization
CONVERGENT MENTAL HEALTH AND WELLNESS, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 7, 2024

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

Authorized official

Name
Karly Trotter, LCSW-CNPI 1295317824
Title
Owner / Psychotherapist
Phone
(443) 840-8994

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
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

213 Old Padonia Rd
Cockeysville, MD 21030-4935

Mailing address

213 Old Padonia Rd
Cockeysville, MD 21030-4935
Phone (443) 840-8994

National Provider Directory

National Provider Directory
Part of
Convergent Mental Health and Wellness LLC

Locations

213 Old Padonia Rd
Cockeysville, MD 21030
Phone (443) 840-8994

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": "1687305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722988800000",
    "number": "1265117790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 OLD PADONIA RD",
            "city": "COCKEYSVILLE",
            "state": "MD",
            "postal_code": "210304935",
            "telephone_number": "443-840-8994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 OLD PADONIA RD",
            "city": "COCKEYSVILLE",
            "state": "MD",
            "postal_code": "210304935",
            "telephone_number": "443-840-8994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONVERGENT MENTAL HEALTH AND WELLNESS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CONVERGENT MENTAL HEALTH AND WELLNESS, LLC",
        "enumeration_date": "2023-06-21",
        "last_updated": "2024-08-07",
        "certification_date": "2024-08-07",
        "status": "A",
        "authorized_official_last_name": "TROTTER",
        "authorized_official_first_name": "KARLY",
        "authorized_official_title_or_position": "OWNER / PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "443-840-8994",
        "authorized_official_credential": "LCSW-C"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cockeysville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2024; 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.