Active NPI
Tanya Y Prince, MHS, CAC-AD
- Addiction (Substance Use Disorder) Counselor
- Baltimore, MD
National Provider Identifier
1497006589
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- AC1790
- Practice address
- 2225 N Charles St
Baltimore, MD 21218-5778 - Phone
- (443) 573-8673
- Fax
- (410) 243-8175
- NPI assigned
- Sep 28, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | AC1790 | MD | Primary |
Addresses
Primary practice location
2225 N Charles St
Baltimore, MD 21218-5778
Mailing address
5620 Wesley Ave
Baltimore, MD 21207-6827
Phone (443) 760-2973
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| AC1790 | Other | MD | BOARD LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AC1790 | MD | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1348790400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1348790400000",
"number": "1497006589",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5620 WESLEY AVE",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212076827",
"telephone_number": "443-760-2973"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2225 N CHARLES ST",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212185778",
"telephone_number": "443-573-8673",
"fax_number": "410-243-8175"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRINCE",
"first_name": "TANYA",
"middle_name": "Y",
"credential": "MHS, CAC-AD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-09-28",
"last_updated": "2012-09-28",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "MD",
"license": "AC1790",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BOARD LICENSE",
"identifier": "AC1790",
"state": "MD"
}
],
"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 Sep 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.