Active NPI
Issaiah House
- Professional Counselor
- Baltimore, MD
National Provider Identifier
1508388364
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LC7034
- Legal business name
- ISSAIAH HOUSE
- Practice address
- 2802 Harford Rd
Baltimore, MD 21218-4953 - Phone
- (443) 882-1943
- NPI assigned
- Jul 13, 2017
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Darryl Braxton, LCPC
- Title
- Owner
- Phone
- (443) 882-1943
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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LC7034 | MD | Primary |
Addresses
Primary practice location
2802 Harford Rd
Baltimore, MD 21218-4953
Mailing address
4331 Parkton St
Baltimore, MD 21229-4521
Phone (443) 882-1943
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 250016700 | Medicaid | MD |
National Provider Directory
National Provider Directory- Tax ID family
- Issaiah House Inc
Other organizations with this tax ID 3
Organizations that report the same tax identification number in the National Provider Directory.
-
- Community/Behavioral Health Agency
- Baltimore, MD
- NPI 1437846623
-
- Mental Illness Community Based Residential Treatment Facility
- Baltimore, MD
- NPI 1518563022
-
- Professional Counselor
- Baltimore, MD
- NPI 1891278024
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": "1499904000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1607558400000",
"number": "1508388364",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4331 PARKTON ST",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212294521",
"telephone_number": "443-882-1943"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2802 HARFORD RD",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212184953",
"telephone_number": "443-882-1943"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ISSAIAH HOUSE",
"organizational_subpart": "NO",
"enumeration_date": "2017-07-13",
"last_updated": "2020-12-10",
"certification_date": "2020-12-10",
"status": "A",
"authorized_official_last_name": "BRAXTON",
"authorized_official_first_name": "DARRYL",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "443-882-1943",
"authorized_official_credential": "LCPC"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Counselor, Professional",
"state": "MD",
"license": "LC7034",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "250016700",
"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 Dec 10, 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.