NPIMap

Organization Active NPI

Upper Bay Counseling & Support Services, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Elkton, MD
National Provider Identifier
1316912652
Registry record updated Jul 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
UPPER BAY COUNSELING & SUPPORT SERVICES, INC.
Practice address
200 Booth Street
Elkton, MD 21921
Phone
(410) 996-5104
Fax
(410) 996-5197
NPI assigned
Feb 21, 2006
Last updated
Jul 14, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2021

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

Authorized official

Name
Mrs. Suanne Blumberg, LCPCNPI 1710031331
Title
Ceo
Phone
(410) 996-5104

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 Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

200 Booth Street
Elkton, MD 21921

Mailing address

200 Booth Street
Elkton, MD 21921
Phone (410) 996-5104

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040121000129 MD Part B Supplier - Clinic/Group Practice 3971405085 Receives reassigned benefits from 31 practitioners
2 other NPIs on this enrollment
Practice locations: Havre de Grace, MD; North East, MD; Elkton, MD

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Upper Bay Counseling Support Services Inc22 organizations share this tax ID, including this one

Other organizations with this tax ID 21

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

View all 21

Practitioners & affiliated clinicians

Practitioners 35

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.

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1140480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626220800000",
    "number": "1316912652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 BOOTH STREET",
            "city": "ELKTON",
            "state": "MD",
            "postal_code": "21921",
            "telephone_number": "410-996-5104",
            "fax_number": "410-996-5197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 BOOTH STREET",
            "city": "ELKTON",
            "state": "MD",
            "postal_code": "21921",
            "telephone_number": "410-996-5104",
            "fax_number": "410-996-5197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPPER BAY COUNSELING & SUPPORT SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-21",
        "last_updated": "2021-07-14",
        "certification_date": "2021-07-14",
        "status": "A",
        "authorized_official_last_name": "BLUMBERG",
        "authorized_official_first_name": "SUANNE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "410-996-5104",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkton, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2021; 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.