Active NPI
Dwayne Purdie
- Mental Health Counselor
- Parkville, MD
National Provider Identifier
1609444553
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 21021092
- Practice address
- 9403 Harford Rd
Parkville, MD 21234-3123 - Phone
- (443) 725-4104
- NPI assigned
- Jun 16, 2021
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 21021092 | MD | Primary |
Addresses
Primary practice location
9403 Harford Rd
Parkville, MD 21234-3123
Mailing address
9403 Harford Rd
Parkville, MD 21234-3123
Phone (443) 725-4104
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 |
|---|---|---|---|
| 21021092 | MD | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1623801600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623801600000",
"number": "1609444553",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9403 HARFORD RD",
"city": "PARKVILLE",
"state": "MD",
"postal_code": "212343123",
"telephone_number": "443-725-4104"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9403 HARFORD RD",
"city": "PARKVILLE",
"state": "MD",
"postal_code": "212343123",
"telephone_number": "443-725-4104"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PURDIE",
"first_name": "DWAYNE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-06-16",
"last_updated": "2021-06-16",
"certification_date": "2021-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MD",
"license": "21021092",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Parkville, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 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.