Individual provider Active NPI

Nathan Brockmeyer, LCPC

  • Professional Counselor
  • Bel Air, MD
National Provider Identifier
1497487797
Registry record updated Jun 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LC12789 Issued in MD
Practice address
120 S Hays St
Suite 300
Bel Air, MD 21014-0797
Phone
(443) 752-4287
NPI assigned
Jun 27, 2022
Last updated
Jun 27, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LC12789 MD Primary

Addresses

Primary practice location

120 S Hays St
Suite 300
Bel Air, MD 21014-0797

Mailing address

3961 Old Federal Hill Rd
Jarrettsville, MD 21084-1633
Phone (443) 752-4287

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240208001121 MD Practitioner - Mental Health Counselor 1456794296 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Harford County Health DepartmentGroup PAC ID 9739108903, 15 clinicians

Practice addresses (Care Compare)

120 S Hays St
Bel Air, MD 21014-3615
Phone (410) 877-2341

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LC12789MDMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Harford County Health Department CurrentSince Jan 1, 2024 Accepting new patients
Harford County Health Department Current Accepting new patients
Harford County Health Department Past Accepting new patients

Locations

120 S Hays St
Bel Air, MD 21014
Phone (410) 877-1033

120 S Hays St
Ste 300
Bel Air, MD 21014
Phone (410) 877-2340

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1656288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656288000000",
    "number": "1497487797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3961 OLD FEDERAL HILL RD",
            "city": "JARRETTSVILLE",
            "state": "MD",
            "postal_code": "210841633",
            "telephone_number": "443-752-4287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 S HAYS ST",
            "address_2": "SUITE 300",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210140797",
            "telephone_number": "443-752-4287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCKMEYER",
        "first_name": "NATHAN",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-06-27",
        "last_updated": "2022-06-27",
        "certification_date": "2022-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LC12789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bel Air, MD

Sources for this page

Verify at the official NPI Registry.