Organization Active NPI

MLJ Counseling & Consulting Firm, LLC

  • Clinical Social Worker
  • Princess Anne, MD
National Provider Identifier
1407467632
Registry record updated Aug 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
MLJ COUNSELING & CONSULTING FIRM, LLC
Practice address
30435 Mount Vernon Rd
Princess Anne, MD 21853-1437
Phone
(443) 257-9442
NPI assigned
Aug 11, 2020
Last updated
Aug 11, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2020

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

Authorized official

Name
Olubusola SariNPI 1730712852
Title
Chief Executive Officer
Phone
(443) 257-9442

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

30435 Mount Vernon Rd
Princess Anne, MD 21853-1437

Mailing address

30435 Mount Vernon Rd
Princess Anne, MD 21853-1437
Phone (443) 257-9442

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201008000143 MD Part B Supplier - Clinic/Group Practice 9335568518 Receives reassigned benefits from 1 practitioner
Practice locations: Crofton, MD

National Provider Directory

National Provider Directory
Tax ID family
MLJ Counseling Consulting Firm LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1597104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597104000000",
    "number": "1407467632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30435 MOUNT VERNON RD",
            "city": "PRINCESS ANNE",
            "state": "MD",
            "postal_code": "218531437",
            "telephone_number": "443-257-9442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30435 MOUNT VERNON RD",
            "city": "PRINCESS ANNE",
            "state": "MD",
            "postal_code": "218531437",
            "telephone_number": "443-257-9442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MLJ COUNSELING & CONSULTING FIRM, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-11",
        "last_updated": "2020-08-11",
        "certification_date": "2020-08-11",
        "status": "A",
        "authorized_official_last_name": "SARI",
        "authorized_official_first_name": "OLUBUSOLA",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "443-257-9442"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Princess Anne, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2020; 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.