NPIMap

Organization Active NPI

Upper Bay Counseling & Support Services, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • North East, MD
National Provider Identifier
1568034007
Registry record updated Jul 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
UPPER BAY COUNSELING & SUPPORT SERVICES, INC
Practice address
71 Flint Dr
North East, MD 21901-3746
Phone
(410) 996-5104
NPI assigned
Jul 14, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2021

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

Authorized official

Name
Mrs. Suanne Blumberg, LCPC
Title
Ceo
Phone
(410) 996-5104

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

71 Flint Dr
North East, MD 21901-3746

Mailing address

200 Booth St
Elkton, MD 21921-5657
Phone (410) 996-5104

Other identifiers 1

IdentifierTypeStateIssuer
922801200MedicaidMD

National Provider Directory

National Provider Directory
Tax ID family
Upper Bay Counseling Support Services Inc22 organizations share this tax ID, including this one

Other organizations with this tax ID 21

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

View all 21

Locations

71 Flint Dr
North East, MD 21901
Phone (410) 620-7161

NPI Registry JSON

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

{
    "created_epoch": "1626220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626220800000",
    "number": "1568034007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 BOOTH ST",
            "city": "ELKTON",
            "state": "MD",
            "postal_code": "219215657",
            "telephone_number": "410-996-5104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "71 FLINT DR",
            "city": "NORTH EAST",
            "state": "MD",
            "postal_code": "219013746",
            "telephone_number": "410-996-5104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPPER BAY COUNSELING & SUPPORT SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-14",
        "last_updated": "2021-07-14",
        "certification_date": "2021-07-14",
        "status": "A",
        "authorized_official_last_name": "BLUMBERG",
        "authorized_official_first_name": "SUANNE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "410-996-5104",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "922801200",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North East, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 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.