Take Charge Wellness and Counseling

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

TAKE CHARGE WELLNESS AND COUNSELING

Practice address

901 Laurie LN
Glen Burnie, MD 21061-2187

Phone

(443) 539-6338

NPI assigned

Feb 19, 2021

Last updated

Feb 19, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Justin Mann

Title

Owner, Psychotherapist

Phone

(443) 539-6338

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1613692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613692800000",
    "number": "1619560679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6710-F RITCHIE HIGHWAY",
            "address_2": "STE F #439",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "21061",
            "telephone_number": "443-539-6338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 LAURIE LN",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210612187",
            "telephone_number": "443-539-6338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAKE CHARGE WELLNESS AND COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-19",
        "last_updated": "2021-02-19",
        "certification_date": "2021-02-19",
        "status": "A",
        "authorized_official_last_name": "MANN",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "OWNER, PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "443-539-6338",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Glen Burnie, MD
• Providers in Glen Burnie, MD by specialty
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 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.