NPIMap

Organization Active NPI

Christian Counseling Center of Annapolis, Inc.

  • Clinical Social Worker
  • Annapolis, MD
National Provider Identifier
1629083357
Registry record updated Sep 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
CHRISTIAN COUNSELING CENTER OF ANNAPOLIS, INC.
Practice address
108 Old Solomons Island Rd
U-7
Annapolis, MD 21401-3845
Phone
(410) 266-8345
Fax
(410) 266-6278
NPI assigned
Jul 30, 2006
Last updated
Sep 5, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2013

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

Authorized official

Name
Miss Sabrina Ann Mackall
Title
Credentialing Sepcialist
Phone
(410) 266-8345

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X
Clinical Psychologist 103TC0700X
Clinical Social Worker 1041C0700X Primary
Psychiatric/Mental Health Registered Nurse 163WP0808X

Addresses

Primary practice location

108 Old Solomons Island Rd
U-7
Annapolis, MD 21401-3845

Mailing address

108 Old Solomons Island Rd
U-7
Annapolis, MD 21401-3845
Phone (410) 266-8345

Other identifiers 1

IdentifierTypeStateIssuer
522901400MedicaidMD

National Provider Directory

National Provider Directory
Tax ID family
Christian Counseling Center of Annapolis Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

108 Old Solomons Island Rd
Ste 7
Annapolis, MD 21401
Phone (410) 266-8345

108 Old Solomons Island Rd
Ste U7
Annapolis, MD 21401
Phone (410) 266-8345

Practitioners & affiliated clinicians

Practitioners 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378339200000",
    "number": "1629083357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 OLD SOLOMONS ISLAND RD",
            "address_2": "U-7",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214013845",
            "telephone_number": "410-266-8345",
            "fax_number": "410-266-6278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 OLD SOLOMONS ISLAND RD",
            "address_2": "U-7",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214013845",
            "telephone_number": "410-266-8345",
            "fax_number": "410-266-6278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTIAN COUNSELING CENTER OF ANNAPOLIS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2013-09-05",
        "status": "A",
        "authorized_official_last_name": "MACKALL",
        "authorized_official_first_name": "SABRINA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "CREDENTIALING SEPCIALIST",
        "authorized_official_telephone_number": "410-266-8345",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "522901400",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Annapolis, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2013; 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.