NPIMap

Organization Active NPI

Fortitude Counseling Center LLC

  • Clinical Social Worker
  • Oxon Hill, MD
National Provider Identifier
1376107813
Registry record updated Apr 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
FORTITUDE COUNSELING CENTER LLC
Practice address
6710 Oxon Hill Rd Ste 210
Oxon Hill, MD 20745-1124
Phone
(240) 863-2820
NPI assigned
Apr 30, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2019

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

Authorized official

Name
Mrs. Cornealius L Stamps, LCSW, LCSW-CNPI 1962709659
Title
Director
Phone
(240) 863-2820

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X

Addresses

Primary practice location

6710 Oxon Hill Rd Ste 210
Oxon Hill, MD 20745-1124

Mailing address

137 National PLZ Ste 300
Oxon Hill, MD 20745-1153
Phone (240) 863-2820

Other practice location 1

137 National Plz Ste 300
Oxon Hill, MD 20745-1153
Phone (240) 863-2820

Other identifiers 1

IdentifierTypeStateIssuer
303314700MedicaidMD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200602001020 DC Part B Supplier - Clinic/Group Practice 6800217720 Receives reassigned benefits from 1 practitioner
Practice locations: Oxon Hill, MD

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.

NPI Registry JSON

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

{
    "created_epoch": "1556582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1556582400000",
    "number": "1376107813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "137 NATIONAL PLZ STE 300",
            "city": "OXON HILL",
            "state": "MD",
            "postal_code": "207451153",
            "telephone_number": "240-863-2820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6710 OXON HILL RD STE 210",
            "city": "OXON HILL",
            "state": "MD",
            "postal_code": "207451124",
            "telephone_number": "240-863-2820"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "137 National Plz Ste 300",
            "address_purpose": "LOCATION",
            "city": "Oxon Hill",
            "state": "MD",
            "postal_code": "207451153",
            "country_code": "US",
            "telephone_number": "240-863-2820",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FORTITUDE COUNSELING CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-30",
        "last_updated": "2019-04-30",
        "status": "A",
        "authorized_official_last_name": "STAMPS",
        "authorized_official_first_name": "CORNEALIUS",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "240-863-2820",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW, LCSW-C"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "303314700",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oxon Hill, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2019; 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.