NPIMap

Organization Active NPI

Guiding Light Therapeutic Services

  • Mental Health Counselor
  • Riverdale, MD
National Provider Identifier
1376056598
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
PRC14502 Issued in DC
Legal business name
GUIDING LIGHT THERAPEUTIC SERVICES
Doing business as
Guiding Light Therapeutic Services
Practice address
4404 Queensbury Rd Ste 105
Riverdale, MD 20737-1074
Phone
(301) 379-4211
NPI assigned
Nov 9, 2017
Last updated
Jun 16, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2018

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

Authorized official

Name
Nodia Marshall, LPC, LCPCNPI 1558740365
Title
Owner
Phone
(301) 379-4211

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X PRC14502 DC Primary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X LC6789 MD

Addresses

Primary practice location

4404 Queensbury Rd Ste 105
Riverdale, MD 20737-1074

Mailing address

4404 Queensbury Rd Ste 105
Riverdale, MD 20737-1074
Phone (301) 379-4211

Other identifiers 1

IdentifierTypeStateIssuer
11556100MedicaidMD

Other names 1

  • Guiding Light Therapeutic Services Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1510185600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529107200000",
    "number": "1376056598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4404 QUEENSBURY RD STE 105",
            "city": "RIVERDALE",
            "state": "MD",
            "postal_code": "207371074",
            "telephone_number": "301-379-4211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4404 QUEENSBURY RD STE 105",
            "city": "RIVERDALE",
            "state": "MD",
            "postal_code": "207371074",
            "telephone_number": "301-379-4211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUIDING LIGHT THERAPEUTIC SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-09",
        "last_updated": "2018-06-16",
        "status": "A",
        "authorized_official_last_name": "MARSHALL",
        "authorized_official_first_name": "NODIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "301-379-4211",
        "authorized_official_credential": "LPC, LCPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "DC",
            "license": "PRC14502",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "LC6789",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "11556100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Guiding Light Therapeutic Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Riverdale, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; 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.