The House of Jude Children Services

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

License

LC-2284 Issued in MD

Legal business name

THE HOUSE OF JUDE CHILDREN SERVICES

Practice address

420 E. 25TH Street
Baltimore, MD 21218

Phone

(410) 705-1331

Fax

(410) 938-2237

NPI assigned

May 29, 2008

Organization subpart

Yes

Parent organization

THE HOUSE OF JUDE CHILDREN SERVICESAs reported in NPPES

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

Authorized official

Name

Edith Augustson, NCC, LCPC, LCADCNPI 1407888274

Title

Owner

Phone

(410) 705-1331

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• The House of Jude Behavioral Health Services Doing business as

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Part of

The House of Jude Children Services

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Edith M Augustson, NCC, LCPC, LCAD-C

  • Professional Counselor
  • Baltimore, MD
  • NPI 1407888274

  Mental Health

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1212019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714694400000",
    "number": "1376701193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 5004",
            "city": "MIDDLE RIVER",
            "state": "MD",
            "postal_code": "21220",
            "telephone_number": "410-705-1331",
            "fax_number": "410-938-2237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 E. 25TH STREET",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21218",
            "telephone_number": "410-705-1331",
            "fax_number": "410-938-2237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE HOUSE OF JUDE CHILDREN SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THE HOUSE OF JUDE CHILDREN SERVICES",
        "enumeration_date": "2008-05-29",
        "last_updated": "2024-05-03",
        "certification_date": "2024-04-30",
        "status": "A",
        "authorized_official_last_name": "AUGUSTSON",
        "authorized_official_first_name": "EDITH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-705-1331",
        "authorized_official_credential": "NCC, LCPC, LCADC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "NCC-93405",
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "MD",
            "license": "LC-2284",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "414755300",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "411699201",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The House of Jude Behavioral Health Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The House of Jude Behavioral Health Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• The Healing Room, Inc.
• The Healing Well, LLC
• The Health Associates
• The Hearing and Speech Agency
• The Holding Space Group
• The House of Nehemiah
• The House of Nehemiah Outreach and Ministries
• The House of the Good Shepherd of the City of Baltimore
• The House Project
• The Hunt Clinic,LLC

• Mental Health Clinic/Center (Including Community Mental Health Center) in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2024; 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.