NPIMap

Organization Active NPI

Away of Change Counseling Service, LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Baltimore, MD
National Provider Identifier
1528671252
Registry record updated Mar 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
AWAY OF CHANGE COUNSELING SERVICE, LLC
Doing business as
Away of Change Counseling Service
Practice address
6609 Reisterstown Rd Ste 206
Baltimore, MD 21215-2315
Phone
(443) 405-3193
Fax
(443) 272-7572
NPI assigned
Aug 24, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2021

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

Authorized official

Name
Ms. Doris Allen, LCADCNPI 1699183335
Title
Ceo & Founder
Phone
(443) 405-3193

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)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary

Addresses

Primary practice location

6609 Reisterstown Rd Ste 206
Baltimore, MD 21215-2315

Mailing address

5310 Old Court Rd Ste 105
Randallstown, MD 21133-5281
Phone (443) 405-3193

Other names 1

  • Away of Change Counseling Service Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Away of Change Counseling Service7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

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": "1598227200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616025600000",
    "number": "1528671252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5310 OLD COURT RD STE 105",
            "city": "RANDALLSTOWN",
            "state": "MD",
            "postal_code": "211335281",
            "telephone_number": "443-405-3193",
            "fax_number": "443-272-7572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6609 REISTERSTOWN RD STE 206",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212152315",
            "telephone_number": "443-405-3193",
            "fax_number": "443-272-7572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AWAY OF CHANGE COUNSELING SERVICE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-24",
        "last_updated": "2021-03-18",
        "certification_date": "2021-02-16",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "DORIS",
        "authorized_official_title_or_position": "CEO & FOUNDER",
        "authorized_official_telephone_number": "443-405-3193",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCADC"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Away of Change Counseling Service",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Away of Change Counseling Service",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Mar 18, 2021; 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.