Organization Active NPI

Urban Trauma Counseling Center, LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Windsor Mill, MD
National Provider Identifier
1558054114
Registry record updated May 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
URBAN TRAUMA COUNSELING CENTER, LLC
Practice address
3100 Lord Baltimore Dr Ste 110
Windsor Mill, MD 21244-5804
Phone
(410) 844-0770
NPI assigned
May 31, 2023
Last updated
May 31, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 31, 2023

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

Authorized official

Name
Shinelle Oglesby, LCPCNPI 1750865796
Title
Ceo/Clinical Director
Phone
(410) 844-0770

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary
Substance Abuse Rehabilitation Facility 324500000X

Addresses

Primary practice location

3100 Lord Baltimore Dr Ste 110
Windsor Mill, MD 21244-5804

Mailing address

3709 Essex Rd
Pikesville, MD 21207-4617
Phone (410) 960-2496

National Provider Directory

National Provider Directory
Tax ID family
Urban Trauma Counseling Center LLC8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1685491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685491200000",
    "number": "1558054114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3709 ESSEX RD",
            "city": "PIKESVILLE",
            "state": "MD",
            "postal_code": "212074617",
            "telephone_number": "410-960-2496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 LORD BALTIMORE DR STE 110",
            "city": "WINDSOR MILL",
            "state": "MD",
            "postal_code": "212445804",
            "telephone_number": "410-844-0770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "URBAN TRAUMA COUNSELING CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-31",
        "last_updated": "2023-05-31",
        "certification_date": "2023-05-22",
        "status": "A",
        "authorized_official_last_name": "OGLESBY",
        "authorized_official_first_name": "SHINELLE",
        "authorized_official_title_or_position": "CEO/CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "410-844-0770",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Windsor Mill, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2023; 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.