Active NPI
Collective Transformation Health Services
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Edgewater, MD
National Provider Identifier
1386163020
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Legal business name
- COLLECTIVE TRANSFORMATION HEALTH SERVICES
- Practice address
- 1642 Shady Side Dr.
Edgewater, MD 21037 - Phone
- (410) 401-3621
- NPI assigned
- Sep 13, 2017
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Sophia Acquah
- Title
- Program Director
- Phone
- (410) 956-6000
Specialties & licenses 12
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | |||
| School Counselor | 101YS0200X | |||
| Clinical Social Worker | 1041C0700X | |||
| Occupational Therapy Assistant | 224Z00000X | |||
| Physical Therapist | 225100000X | |||
| Speech-Language Pathologist | 235Z00000X | |||
| Case Management Agency | 251B00000X | |||
| Public Health or Welfare Agency | 251K00000X | |||
| Community/Behavioral Health Agency | 251S00000X | |||
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | Primary | ||
| Adolescent and Children Mental Health Clinic/Center | 261QM0855X | |||
| Rehabilitation Clinic/Center | 261QR0400X |
Addresses
Primary practice location
1642 Shady Side Dr.
Edgewater, MD 21037
Mailing address
1642 Shady Side Dr
Edgewater, MD 21037-1934
Phone (410) 956-6000
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1505260800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1658361600000",
"number": "1386163020",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1642 SHADY SIDE DR",
"city": "EDGEWATER",
"state": "MD",
"postal_code": "210371934",
"telephone_number": "410-956-6000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1642 SHADY SIDE DR.",
"city": "EDGEWATER",
"state": "MD",
"postal_code": "21037",
"telephone_number": "410-401-3621"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "COLLECTIVE TRANSFORMATION HEALTH SERVICES",
"organizational_subpart": "NO",
"enumeration_date": "2017-09-13",
"last_updated": "2022-07-21",
"status": "A",
"authorized_official_last_name": "ACQUAH",
"authorized_official_first_name": "SOPHIA",
"authorized_official_title_or_position": "PROGRAM DIRECTOR",
"authorized_official_telephone_number": "410-956-6000"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Counselor, Professional",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YS0200X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Counselor, School",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": false
},
{
"code": "224Z00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Occupational Therapy Assistant",
"state": null,
"license": null,
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Speech-Language Pathologist",
"state": null,
"license": null,
"primary": false
},
{
"code": "251B00000X",
"taxonomy_group": "",
"desc": "Case Management",
"state": null,
"license": null,
"primary": false
},
{
"code": "251K00000X",
"taxonomy_group": "",
"desc": "Public Health or Welfare",
"state": null,
"license": null,
"primary": false
},
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "261QM0801X",
"taxonomy_group": "",
"desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
"state": null,
"license": null,
"primary": true
},
{
"code": "261QM0855X",
"taxonomy_group": "",
"desc": "Clinic/Center, Adolescent and Children Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "261QR0400X",
"taxonomy_group": "",
"desc": "Clinic/Center, Rehabilitation",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Edgewater, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.