Pridgett Harmon
Individual provider Active NPI Professional Counselor · Salisbury MD, MD
NPI 1508404997 · NPPES record last updated Nov 16, 2022
Key facts
- NPI
- 1508404997
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- LC12798 (MD)
- Practice address
- 2324 West Zion Road
Suite 112
Salisbury MD, MD 21801 - Phone
- (800) 867-2395
- Fax
- (410) 443-0842
- NPI assigned
- Dec 16, 2019
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in DC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241210002754 | DC | Practitioner - Mental Health Counselor | 1052847332 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LGP10029 | MD | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grow Healthcare Group PA | Mental Health | Current |
Accepting new patients |
Locations
66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711
8300 Boone Blvd
Ste 500
Vienna, VA 22182
Phone (703) 884-2598
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LGP10029 | MD | |
| Mental Health Counselor | 101YM0800X | |||
| Professional Counselor | 101YP2500X | LGP10029 | MD | |
| Professional Counselor | 101YP2500X | LC12798 | MD | Yes |
Addresses
Primary practice location
2324 West Zion Road
Suite 112
Salisbury MD, MD 21801
Mailing address
1010 Limestone CT
Salisbury, MD 21804-8636
Other practice location 1
514 Poplar St
Cambridge, MD 21613-1834
Phone (800) 867-2395
Other practice location 2
8737 Brooks Dr Ste 108
Easton, MD 21601-7474
Phone (800) 867-2395
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 16, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.