NPIMap

Organization Active NPI

Psychotherapeutic Community Service Association

  • Group Psychotherapy Psychologist
  • Lutherville, MD
National Provider Identifier
1477628592
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Group Psychotherapy PsychologistTaxonomy code 103TP2701X
Legal business name
PSYCHOTHERAPEUTIC COMMUNITY SERVICE ASSOCIATION
Practice address
1300 York Rd
Suite 149
Lutherville, MD 21093-6016
Phone
(410) 823-7784
Fax
(410) 823-7633
NPI assigned
Nov 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Randall Cooper, CPA
Title
Chief Financial Officer
Phone
(410) 778-9114

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Group Psychotherapy PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TP2701X Primary

Addresses

Primary practice location

1300 York Rd
Suite 149
Lutherville, MD 21093-6016

Mailing address

PO Box 690
Chestertown, MD 21620-0690
Phone (410) 778-9114

Other names 1

  • BALTIMORE COUNTY Other name

National Provider Directory

National Provider Directory
Tax ID family
Baltimore County3 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.

NPI Registry JSON

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1477628592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 690",
            "city": "CHESTERTOWN",
            "state": "MD",
            "postal_code": "216200690",
            "telephone_number": "410-778-9114",
            "fax_number": "410-778-7988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 YORK RD",
            "address_2": "SUITE 149",
            "city": "LUTHERVILLE",
            "state": "MD",
            "postal_code": "210936016",
            "telephone_number": "410-823-7784",
            "fax_number": "410-823-7633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHOTHERAPEUTIC COMMUNITY SERVICE ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "COOPER",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "410-778-9114",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "103TP2701X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Group Psychotherapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BALTIMORE COUNTY",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lutherville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.