NPIMap

Organization Active NPI

Divine Touch Therapeutic Counseling and Mentoring Services , LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Pasadena, MD
National Provider Identifier
1386155968
Registry record updated Oct 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
DIVINE TOUCH THERAPEUTIC COUNSELING AND MENTORING SERVICES , LLC
Practice address
107 Mountain Rd Ste D
Pasadena, MD 21122-7159
Phone
(240) 481-9962
NPI assigned
Oct 23, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2017

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

Authorized official

Name
Mrs. Boladale Wuraola Adegoroye, LCPCNPI 1790174506
Title
Clinical Director
Phone
(240) 481-9962

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
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary
Adult Mental Health Clinic/Center 261QM0850X
Adolescent and Children Mental Health Clinic/Center 261QM0855X

Addresses

Primary practice location

107 Mountain Rd Ste D
Pasadena, MD 21122-7159

Mailing address

107 Mountain Rd Ste D
Pasadena, MD 21122-7159

Other identifiers 1

IdentifierTypeStateIssuer
1155938MedicaidMD

National Provider Directory

National Provider Directory

Locations

107 Mountain Rd
Ste D
Pasadena, MD 21122
Phone (240) 481-9962

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": "1508716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1508716800000",
    "number": "1386155968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 MOUNTAIN RD STE D",
            "city": "PASADENA",
            "state": "MD",
            "postal_code": "211227159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 MOUNTAIN RD STE D",
            "city": "PASADENA",
            "state": "MD",
            "postal_code": "211227159",
            "telephone_number": "240-481-9962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE TOUCH THERAPEUTIC COUNSELING AND MENTORING SERVICES , LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-23",
        "last_updated": "2017-10-23",
        "status": "A",
        "authorized_official_last_name": "ADEGOROYE",
        "authorized_official_first_name": "BOLADALE",
        "authorized_official_middle_name": "WURAOLA",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "240-481-9962",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1155938",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2017; 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.