NPIMap

Organization Active NPI

Mergence, Inc

  • Professional Counselor
  • Baltimore, MD
National Provider Identifier
1275927683
Registry record updated Jun 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LC6047 Issued in MD
Legal business name
MERGENCE, INC
Practice address
5209 York Rd
Suite 15
Baltimore, MD 21212-4225
Phone
(301) 769-6402
NPI assigned
Mar 24, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2015

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

Authorized official

Name
Ms. Tiesha Mia Cohen, LCPC
Title
Co-Founder/Clinical Consultant
Phone
(301) 769-6402

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X LC6047 MD Primary

Addresses

Primary practice location

5209 York Rd
Suite 15
Baltimore, MD 21212-4225

Mailing address

5209 York Rd
B-10
Baltimore, MD 21212-4225
Phone (301) 769-6402

National Provider Directory

National Provider Directory

Locations

5209 York Rd
Ste 15
Baltimore, MD 21212
Phone (301) 769-6402

5209 York Rd
Ste B10
Baltimore, MD 21212
Phone (301) 769-6402

NPI Registry JSON

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

{
    "created_epoch": "1427155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433808000000",
    "number": "1275927683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5209 YORK RD",
            "address_2": "B-10",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212124225",
            "telephone_number": "301-769-6402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5209 YORK RD",
            "address_2": "SUITE 15",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212124225",
            "telephone_number": "301-769-6402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERGENCE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-24",
        "last_updated": "2015-06-09",
        "status": "A",
        "authorized_official_last_name": "COHEN",
        "authorized_official_first_name": "TIESHA",
        "authorized_official_middle_name": "MIA",
        "authorized_official_title_or_position": "CO-FOUNDER/CLINICAL CONSULTANT",
        "authorized_official_telephone_number": "301-769-6402",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LC6047",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 9, 2015; 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.