NPIMap

Organization Active NPI

Humble Beginnings Recovery LLC

  • Substance Abuse Rehabilitation Facility
  • Baltimore, MD
National Provider Identifier
1588246995
Registry record updated Apr 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
HUMBLE BEGINNINGS RECOVERY LLC
Doing business as
Humble Beginnings Recovery LLC
Practice address
3935 Southern Ave
Baltimore, MD 21206-5537
Phone
(443) 707-5558
NPI assigned
Apr 25, 2021
Last updated
Apr 30, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2021

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

Authorized official

Name
Jesse Waterman, LMSW, LGADCNPI 1124585211
Title
Program Director
Phone
(443) 707-5558

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) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X
Substance Abuse Rehabilitation Facility 324500000X Primary

Addresses

Primary practice location

3935 Southern Ave
Baltimore, MD 21206-5537

Mailing address

1103 Walnut Wood Rd
Hunt Valley, MD 21030-5403
Phone (443) 707-5558

Other names 1

  • Humble Beginnings Recovery LLC Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
21D2273817Humble Beginnings Recovery LLC3935 Southern Ave, Baltimore, MD 21206Certificate of waiverDec 19, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

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": "1619308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619740800000",
    "number": "1588246995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1103 WALNUT WOOD RD",
            "city": "HUNT VALLEY",
            "state": "MD",
            "postal_code": "210305403",
            "telephone_number": "443-707-5558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3935 SOUTHERN AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212065537",
            "telephone_number": "443-707-5558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUMBLE BEGINNINGS RECOVERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-25",
        "last_updated": "2021-04-30",
        "certification_date": "2021-04-30",
        "status": "A",
        "authorized_official_last_name": "WATERMAN",
        "authorized_official_first_name": "JESSE",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "443-707-5558",
        "authorized_official_credential": "LMSW, LGADC"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Humble Beginnings Recovery LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Humble Beginnings Recovery LLC",
            "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 Apr 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.