Community Outreach Services, Inc.

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

COMMUNITY OUTREACH SERVICES, INC.

Practice address

6215 Greenbelt Rd
Suite 206
Berwyn Heights, MD 20740-2355

Phone

(301) 345-1459

Fax

(301) 345-1305

NPI assigned

Sep 20, 2013

Last updated

Sep 20, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Michael W. Nettles, LPC,LCPC,MAC

Title

Owner/Clinical Director

Phone

(301) 345-1459

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1379635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1379635200000",
    "number": "1447686597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6215 GREENBELT RD",
            "address_2": "SUITE 206",
            "city": "BERWYN HEIGHTS",
            "state": "MD",
            "postal_code": "207402355",
            "telephone_number": "301-345-1459",
            "fax_number": "301-345-1305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6215 GREENBELT RD",
            "address_2": "SUITE 206",
            "city": "BERWYN HEIGHTS",
            "state": "MD",
            "postal_code": "207402355",
            "telephone_number": "301-345-1459",
            "fax_number": "301-345-1305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY OUTREACH SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-20",
        "last_updated": "2013-09-20",
        "status": "A",
        "authorized_official_last_name": "NETTLES",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "OWNER/CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "301-345-1459",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LPC,LCPC,MAC"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Substance Use Disorder Rehabilitation Clinic/Center in Berwyn Heights, MD
• Providers in Berwyn Heights, MD by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2013; 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.