NPIMap

Organization Active NPI

Matclinic Physicians Practice Group LLC

  • Addiction (Substance Use Disorder) Counselor
  • Towson, MD
National Provider Identifier
1528610086
Registry record updated May 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Legal business name
MATCLINIC PHYSICIANS PRACTICE GROUP LLC
Practice address
40 York Rd Ste 201
Towson, MD 21204-5243
Phone
(410) 220-0780
Fax
(410) 862-0150
NPI assigned
Jul 15, 2019
Last updated
May 11, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 11, 2022

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

Authorized official

Name
Dan Reck
Title
Manager
Phone
(410) 220-0780

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X Primary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X

Addresses

Primary practice location

40 York Rd Ste 201
Towson, MD 21204-5243

Mailing address

PO Box 9068
Baltimore, MD 21222-0768
Phone (410) 220-0720

Other identifiers 1

IdentifierTypeStateIssuer
561008700MedicaidMD

National Provider Directory

National Provider Directory
Tax ID family
Matclinic Physicians Practice Group LLC33 organizations share this tax ID, including this one

Other organizations with this tax ID 32

Organizations that report the same tax identification number in the National Provider Directory.

View all 32

NPI Registry JSON

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

{
    "created_epoch": "1563148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652227200000",
    "number": "1528610086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9068",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212220768",
            "telephone_number": "410-220-0720",
            "fax_number": "410-862-0150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 YORK RD STE 201",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212045243",
            "telephone_number": "410-220-0780",
            "fax_number": "410-862-0150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATCLINIC PHYSICIANS PRACTICE GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-15",
        "last_updated": "2022-05-11",
        "certification_date": "2022-05-11",
        "status": "A",
        "authorized_official_last_name": "RECK",
        "authorized_official_first_name": "DAN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "410-220-0780"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "561008700",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Towson, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 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.