NPIMap

Organization Active NPI

MRT Counseling & Wellness Center, LLC

  • Clinical Social Worker
  • Baltimore, MD
National Provider Identifier
1366824377
Registry record updated Aug 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
13822 Issued in MD
Legal business name
MRT COUNSELING & WELLNESS CENTER, LLC
Doing business as
MRT COUNSELING & WELLNESS CENTER, LLC.
Practice address
6600 York Rd
Suite 109a
Baltimore, MD 21212-2028
Phone
(410) 689-8757
NPI assigned
Jun 25, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2015

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

Authorized official

Name
Marlon R Tinker, LCSWC, CAC-AD
Title
Owner/Provider
Phone
(410) 689-8757

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X AC1591 MD
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 13822 MD Primary

Addresses

Primary practice location

6600 York Rd
Suite 109a
Baltimore, MD 21212-2028

Mailing address

6600 York Rd
Suite 109a
Baltimore, MD 21212-2028
Phone (410) 689-8757

Other identifiers 1

IdentifierTypeStateIssuer
324303600MedicaidMD

Other names 1

  • MRT COUNSELING & WELLNESS CENTER, LLC. Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1435190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439510400000",
    "number": "1366824377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 YORK RD",
            "address_2": "SUITE 109A",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212122028",
            "telephone_number": "410-689-8757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6600 YORK RD",
            "address_2": "SUITE 109A",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212122028",
            "telephone_number": "410-689-8757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MRT COUNSELING & WELLNESS CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-25",
        "last_updated": "2015-08-14",
        "status": "A",
        "authorized_official_last_name": "TINKER",
        "authorized_official_first_name": "MARLON",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "410-689-8757",
        "authorized_official_credential": "LCSWC, CAC-AD"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MD",
            "license": "AC1591",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "13822",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "324303600",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MRT COUNSELING & WELLNESS CENTER, LLC.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Aug 14, 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.