NPIMap

Organization Active NPI

New Life Addiction Counseling Services, Inc.

  • Psychiatry Physician
  • Pasadena, MD
National Provider Identifier
1457629255
Registry record updated Dec 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
NEW LIFE ADDICTION COUNSELING SERVICES, INC.
Practice address
2528 Mountain Rd
#204
Pasadena, MD 21122-7203
Phone
(410) 255-4475
Fax
(410) 255-6277
NPI assigned
Dec 7, 2011
Last updated
Dec 7, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2011

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

Authorized official

Name
Ms. Beverly Ann Ervin
Title
Ceo/Director
Phone
(410) 255-4475

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X NU Primary

Addresses

Primary practice location

2528 Mountain Rd
#204
Pasadena, MD 21122-7203

Mailing address

2528 Mountain Rd
#204
Pasadena, MD 21122-7203
Phone (410) 255-4475

Other identifiers 1

IdentifierTypeStateIssuer
200731200MedicaidMD

National Provider Directory

National Provider Directory
Tax ID family
New Life Addiction Counseling Services Inc8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

NPI Registry JSON

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

{
    "created_epoch": "1323216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323216000000",
    "number": "1457629255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2528 MOUNTAIN RD",
            "address_2": "#204",
            "city": "PASADENA",
            "state": "MD",
            "postal_code": "211227203",
            "telephone_number": "410-255-4475",
            "fax_number": "410-255-6277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2528 MOUNTAIN RD",
            "address_2": "#204",
            "city": "PASADENA",
            "state": "MD",
            "postal_code": "211227203",
            "telephone_number": "410-255-4475",
            "fax_number": "410-255-6277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW LIFE ADDICTION COUNSELING SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-07",
        "last_updated": "2011-12-07",
        "status": "A",
        "authorized_official_last_name": "ERVIN",
        "authorized_official_first_name": "BEVERLY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "CEO/DIRECTOR",
        "authorized_official_telephone_number": "410-255-4475",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200731200",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2011; 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.