Active NPI
Brian Shavitz, LCPC
- Professional Counselor
- Essex, MD
National Provider Identifier
1598161572
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LC6020
- Practice address
- 621 Stemmers Run Rd Ste E
Essex, MD 21221-3386 - Phone
- (410) 574-2500
- Fax
- (410) 574-4478
- NPI assigned
- Nov 18, 2014
- Last updated
- Nov 18, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LC6020 | MD | Primary |
Addresses
Primary practice location
621 Stemmers Run Rd Ste E
Essex, MD 21221-3386
Mailing address
1040 Park Ave Ste 103
Baltimore, MD 21201-5633
Phone (410) 837-3977
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LC6020 | MD | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Friends Research Institute, Inc. | Past | Accepting new patients | |
| Friends Research Institute, Inc. | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Epoch Counseling Center
- Addiction (Substance Use Disorder) Counselor
- Essex, MD
- NPI 1083772743
-
dba Epoch Counseling Center
- Mental Health Counselor
- Essex, MD
- NPI 1154674224
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1416268800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1416268800000",
"number": "1598161572",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1040 PARK AVE STE 103",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212015633",
"telephone_number": "410-837-3977",
"fax_number": "410-752-4218"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "621 STEMMERS RUN RD STE E",
"city": "ESSEX",
"state": "MD",
"postal_code": "212213386",
"telephone_number": "410-574-2500",
"fax_number": "410-574-4478"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAVITZ",
"first_name": "BRIAN",
"credential": "LCPC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-11-18",
"last_updated": "2014-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MD",
"license": "LC6020",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Essex, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.