NPIMap

Organization Active NPI

Graceful Dove Recovery, LLC

  • Addiction (Substance Use Disorder) Counselor
  • Baltimore, MD
National Provider Identifier
1609596105
Registry record updated Sep 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Legal business name
GRACEFUL DOVE RECOVERY, LLC
Practice address
214 E Randall St
Baltimore, MD 21230-4652
Phone
(240) 712-1851
NPI assigned
Sep 2, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2022

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

Authorized official

Name
Melissa Christine Lee Furmage
Title
Owner
Phone
(240) 712-1851

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X Primary

Addresses

Primary practice location

214 E Randall St
Baltimore, MD 21230-4652

Mailing address

214 E Randall St
Baltimore, MD 21230-4652
Phone (240) 712-1851

National Provider Directory

National Provider Directory

Locations

214 E Randall St
Baltimore, MD 21230
Phone (240) 712-1851

NPI Registry JSON

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

{
    "created_epoch": "1662076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662076800000",
    "number": "1609596105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 E RANDALL ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212304652",
            "telephone_number": "240-712-1851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 E RANDALL ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212304652",
            "telephone_number": "240-712-1851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACEFUL DOVE RECOVERY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-02",
        "last_updated": "2022-09-02",
        "certification_date": "2022-08-11",
        "status": "A",
        "authorized_official_last_name": "FURMAGE",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "CHRISTINE LEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "240-712-1851"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Sep 2, 2022; 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.