Inspiring Change Mental Health Services, LLC.

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

INSPIRING CHANGE MENTAL HEALTH SERVICES, LLC.

Practice address

4654 York Rd # 1a
Baltimore, MD 21212-4726

Phone

(410) 258-6714

NPI assigned

Oct 22, 2019

Last updated

Aug 12, 2021By the provider in NPPES

Organization subpart

Yes

Parent organization

INSPIRING CHANGE MENTAL HEALTH SERVICES, LLCAs reported in NPPES

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

Authorized official

Name

Shaquanna Foster-DotsonNPI 1770997520

Title

Ceo

Phone

(410) 258-6714

Specialties & licenses 6

Addresses

Electronic endpoints 1

Tax ID family

Inspiring Change Mental Health Services LLC3 organizations share this tax ID, including this one

Part of

Inspiring Change Mental Health Services LLC

Other organizations with this tax ID 2

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

• Inspiring Change Mental Health Services, LLC.

  • Community/Behavioral Health Agency
  • Baltimore, MD
  • NPI 1497365654
  NPD tax ID
• Inspiring Change Mental Health Services, LLC.

  dba Inspiring Change Community Outreach Center

  • Substance Abuse Rehabilitation Facility
  • Baltimore, MD
  • NPI 1679142657
  NPD tax ID

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.

• Shaquanna Foster-Dotson, MSSA, LCSWC

  • Clinical Social Worker
  • Baltimore, MD
  • NPI 1770997520
  NPD (past) Authorized official

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

{
    "created_epoch": "1571702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628726400000",
    "number": "1285277343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7036",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212160036",
            "telephone_number": "410-258-6714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4654 YORK RD # 1A",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212124726",
            "telephone_number": "410-258-6714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INSPIRING CHANGE MENTAL HEALTH SERVICES, LLC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "INSPIRING CHANGE MENTAL HEALTH SERVICES, LLC",
        "enumeration_date": "2019-10-22",
        "last_updated": "2021-08-12",
        "certification_date": "2021-08-12",
        "status": "A",
        "authorized_official_last_name": "FOSTER-DOTSON",
        "authorized_official_first_name": "SHAQUANNA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "410-258-6714"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3245S0500X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Baltimore",
            "affiliation": "N",
            "endpointDescription": "foster-dotson@inspiringchangemhs.org",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4654 York Rd",
            "city": "Baltimore",
            "state": "MD",
            "country_code": "US",
            "postal_code": "212124726",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Inspiring & Empowering Change, LLC
• Inspiring Change Mental Health Services, LLC
• Inspiring Change Mental Health Services, LLC.
• Inspiring Change Mental Health Services, LLC. (Inspiring Change Community Outreach Center)
• Inspiring Minds Inc
• Inspirit Counseling Services, Inc.
• Institute for Dermatopathology, Inc. (Ameripath Mid Atlantic)

• Mental Health Clinic/Center (Including Community Mental Health Center) in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 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.