NPIMap

Organization Active NPI

Upper Bay Counseling & Support Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Havre de Grace, MD
National Provider Identifier
1629524186
Registry record updated Aug 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
UPPER BAY COUNSELING & SUPPORT SERVICES
Practice address
626 Revolution St
Havre de Grace, MD 21078-3320
Phone
(410) 939-8744
Fax
(410) 398-3416
NPI assigned
Aug 25, 2016
Last updated
Aug 25, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2016

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

Authorized official

Name
Dr. Rich Bayer, PHD
Title
Ceo
Phone
(410) 996-5104

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X MD Primary

Addresses

Primary practice location

626 Revolution St
Havre de Grace, MD 21078-3320

Mailing address

200 Booth St
Elkton, MD 21921-5657
Phone (410) 996-5104

Other identifiers 1

IdentifierTypeStateIssuer
922801202MedicaidMD

National Provider Directory

National Provider Directory
Tax ID family
Upper Bay Counseling Support Services Inc22 organizations share this tax ID, including this one

Other organizations with this tax ID 21

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

View all 21

Locations

626 Revolution St
Havre de Grace, MD 21078
Phone (410) 939-8744

NPI Registry JSON

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

{
    "created_epoch": "1472083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472083200000",
    "number": "1629524186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 BOOTH ST",
            "city": "ELKTON",
            "state": "MD",
            "postal_code": "219215657",
            "telephone_number": "410-996-5104",
            "fax_number": "410-398-3416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "626 REVOLUTION ST",
            "city": "HAVRE DE GRACE",
            "state": "MD",
            "postal_code": "210783320",
            "telephone_number": "410-939-8744",
            "fax_number": "410-398-3416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPPER BAY COUNSELING & SUPPORT SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-25",
        "last_updated": "2016-08-25",
        "status": "A",
        "authorized_official_last_name": "BAYER",
        "authorized_official_first_name": "RICH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "410-996-5104",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "MD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "922801202",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Havre de Grace, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2016; 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.