NPIMap

Organization Active NPI

Humble Beginnings Recovery LLC

  • Substance Abuse Rehabilitation Facility
  • Baltimore, MD
National Provider Identifier
1487387619
Registry record updated Jul 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
HUMBLE BEGINNINGS RECOVERY LLC
Doing business as
Humble Beginnings Recovery LLC
Practice address
4515 Bowleys LN
Baltimore, MD 21206-6641
Phone
(443) 707-5558
Fax
(833) 301-1994
NPI assigned
Jul 6, 2022
Organization subpart
Yes
Parent organization
HUMBLE BEGINNINGS RECOVERY LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 6, 2022

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

Authorized official

Name
Jesse Waterman, LCSW-C, LCADCNPI 1124585211
Title
Co-Owner
Phone
(443) 971-1451

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
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X
Substance Abuse Rehabilitation Facility 324500000X Primary

Addresses

Primary practice location

4515 Bowleys LN
Baltimore, MD 21206-6641

Mailing address

1103 Walnut Wood Rd
Hunt Valley, MD 21030-5403
Phone (443) 971-1451

Other identifiers 1

IdentifierTypeStateIssuer
1588246995MedicaidMD

Other names 1

  • Humble Beginnings Recovery LLC Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL jesse@hbrmaryland.com Direct Humble Beginnings Recovery LLC

National Provider Directory

National Provider Directory
Part of
Humble Beginnings Recovery LLC

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

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": "1657065600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657065600000",
    "number": "1487387619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1103 WALNUT WOOD RD",
            "city": "HUNT VALLEY",
            "state": "MD",
            "postal_code": "210305403",
            "telephone_number": "443-971-1451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4515 BOWLEYS LN",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212066641",
            "telephone_number": "443-707-5558",
            "fax_number": "833-301-1994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUMBLE BEGINNINGS RECOVERY LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HUMBLE BEGINNINGS RECOVERY LLC",
        "enumeration_date": "2022-07-06",
        "last_updated": "2022-07-06",
        "certification_date": "2022-06-27",
        "status": "A",
        "authorized_official_last_name": "WATERMAN",
        "authorized_official_first_name": "JESSE",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "443-971-1451",
        "authorized_official_credential": "LCSW-C, LCADC"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1588246995",
            "state": "MD"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "jesse@hbrmaryland.com",
            "affiliation": "Y",
            "endpointDescription": "Email",
            "affiliationName": "Humble Beginnings Recovery LLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "4515 Bowleys Ln",
            "city": "Baltimore",
            "state": "MD",
            "country_code": "US",
            "postal_code": "212066641",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Humble Beginnings Recovery LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 6, 2022; 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.