Maryland Family Therapy, LLC

Primary specialty

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

Legal business name

MARYLAND FAMILY THERAPY, LLC

Practice address

100 Harborview Dr Unit 2109
Baltimore, MD 21230-5449

Phone

(617) 659-5299

NPI assigned

Nov 26, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Princess Souvenir, DBH, LCPCNPI 1396174785

Title

Partner

Phone

(313) 815-5967

Specialties & licenses 2

Addresses

Practitioners 1

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

• Princess Souvenir, LCPC

  • Mental Health Counselor
  • Burtonsville, MD
  • NPI 1396174785

  Professional

  NPD Authorized official

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

{
    "created_epoch": "1732579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732579200000",
    "number": "1386460038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HARBORVIEW DR UNIT 2109",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212305449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HARBORVIEW DR UNIT 2109",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212305449",
            "telephone_number": "617-659-5299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYLAND FAMILY THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-26",
        "last_updated": "2024-11-26",
        "certification_date": "2024-11-26",
        "status": "A",
        "authorized_official_last_name": "SOUVENIR",
        "authorized_official_first_name": "PRINCESS",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "313-815-5967",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DBH, LCPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "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
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maryland Family Care, Inc.
• Maryland Family Care, Inc.
• Maryland Family Care, Inc.
• Maryland Family Care, Inc.
• Maryland Family Care, Inc.
• Maryland General Care
• Maryland General Clinical Practice Group, Inc.
• Maryland General Clinical Practice Group, Inc.
• Maryland General Clinical Practice Group, Inc.
• Maryland General Clinical Practice Group, Inc.

• 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 Nov 26, 2024; 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.