Organization Active NPI

Collective Transformation Health Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Edgewater, MD
National Provider Identifier
1386163020
Registry record updated Jul 21, 2022
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
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

Updated by the provider on Jul 21, 2022

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)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X
School CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YS0200X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Occupational Therapy AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 224Z00000X
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 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 Directory

NPI 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.

Verify at the official NPI Registry.