Organization Active NPI

Institute for Faith Based Leadership & Philanthropy Inc.

  • Mental Health Counselor
  • Baltimore, MD
National Provider Identifier
1467973081
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LC7958 Issued in MD
Legal business name
INSTITUTE FOR FAITH BASED LEADERSHIP & PHILANTHROPY INC.
Practice address
3311 Bateman Ave
Baltimore, MD 21216-1807
Phone
(410) 908-0063
NPI assigned
Jul 5, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Theresa Harris, M. ED, LCPCNPI 1518488139
Title
Secretary
Phone
(410) 908-0063

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LC7958 MD Primary
Professional Counselor 101YP2500X LC7958 MD

Addresses

Primary practice location

3311 Bateman Ave
Baltimore, MD 21216-1807

Mailing address

3311 Bateman Ave
Baltimore, MD 21216-1807
Phone (410) 908-0063

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240202000060 MD Part B Supplier - Clinic/Group Practice 6406209733 Receives reassigned benefits from 1 practitioner
Practice locations: Baltimore, MD

National Provider Directory

National Provider Directory

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": "1499212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1467973081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3311 BATEMAN AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212161807",
            "telephone_number": "410-908-0063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3311 BATEMAN AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212161807",
            "telephone_number": "410-908-0063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INSTITUTE FOR FAITH BASED LEADERSHIP & PHILANTHROPY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-05",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "THERESA",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "410-908-0063",
        "authorized_official_credential": "M. ED, LCPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "LC7958",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LC7958",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.