NPIMap

Organization Active NPI

Destilee Health Care

  • Clinical Social Worker
  • Randallstown, MD
National Provider Identifier
1457582900
Registry record updated Jul 31, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
11897 Issued in MD
Legal business name
DESTILEE HEALTH CARE
Practice address
9006 Liberty Rd
Suite 2
Randallstown, MD 21133-3931
Phone
(410) 496-5444
Fax
(443) 303-4320
NPI assigned
Jul 31, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2009

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

Authorized official

Name
Dr. Vanessa Chappell-Lee, LCSW-C
Title
Director
Phone
(410) 496-5444

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 11897 MD Primary

Addresses

Primary practice location

9006 Liberty Rd
Suite 2
Randallstown, MD 21133-3931

Mailing address

9006 Liberty Rd
Suite 2
Randallstown, MD 21133-3931
Phone (410) 496-5444

National Provider Directory

National Provider Directory
Tax ID family
Destilee Health Care3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

9006 Liberty Rd
Ste 2
Randallstown, MD 21133
Phone (410) 496-5444

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1248998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248998400000",
    "number": "1457582900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9006 LIBERTY RD",
            "address_2": "SUITE 2",
            "city": "RANDALLSTOWN",
            "state": "MD",
            "postal_code": "211333931",
            "telephone_number": "410-496-5444",
            "fax_number": "443-303-4320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9006 LIBERTY RD",
            "address_2": "SUITE 2",
            "city": "RANDALLSTOWN",
            "state": "MD",
            "postal_code": "211333931",
            "telephone_number": "410-496-5444",
            "fax_number": "443-303-4320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESTILEE HEALTH CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-31",
        "last_updated": "2009-07-31",
        "status": "A",
        "authorized_official_last_name": "CHAPPELL-LEE",
        "authorized_official_first_name": "VANESSA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "410-496-5444",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "LCSW-C"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "11897",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Randallstown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2009; 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.