Kiddie Koach PRP LLC.

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

KIDDIE KOACH PRP LLC.

Practice address

9922 Liberty Rd
Randallstown, MD 21133-1804

Phone

(443) 657-3345

NPI assigned

Feb 27, 2019

Last updated

Nov 12, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Nicole PriceNPI 1811596547

Title

Founder

Phone

(443) 657-3345

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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.

• Nicole Price

  • Mental Health Counselor
  • Randallstown, MD
  • NPI 1811596547
  NPD Authorized official
• Shakeya Miller

  • Behavior Technician
  • Randallstown, MD
  • NPI 1144826116
  NPD

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

{
    "created_epoch": "1551225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605139200000",
    "number": "1376000158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9922 LIBERTY RD",
            "city": "RANDALLSTOWN",
            "state": "MD",
            "postal_code": "211331804",
            "telephone_number": "443-657-3345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9922 LIBERTY RD",
            "city": "RANDALLSTOWN",
            "state": "MD",
            "postal_code": "211331804",
            "telephone_number": "443-657-3345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDDIE KOACH PRP LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-27",
        "last_updated": "2020-11-12",
        "certification_date": "2020-11-12",
        "status": "A",
        "authorized_official_last_name": "PRICE",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "FOUNDER",
        "authorized_official_telephone_number": "443-657-3345"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Myrna Khairy
• Ijaz A Khan, M.D.
• Kimberly Hui-Ling Khoo
• Alex Khristenko
• Daniel Kiang, PHARMD
• Mohammed G Kiddugavu, MD
• Asra Farooqui Kidwai
• Naomi N Kiguru, COTA
• King Samuel Health Inc
• Karen M King, RN

• Community/Behavioral Health Agency in Randallstown, MD
• Providers in Randallstown, MD by specialty
• Community/Behavioral Health Agency in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2020; 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.