Individual provider Active NPI

Charles Matthew Mazick, LGPC

  • Mental Health Counselor
  • Columbia, MD
National Provider Identifier
1629756606
Registry record updated Jul 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LGP13378 Issued in MD
Practice address
8894 Stanford Blvd
Columbia, MD 21045-4794
Phone
(443) 718-0059
Fax
(347) 903-6927
NPI assigned
Jul 10, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LGP13378 MD Primary

Addresses

Primary practice location

8894 Stanford Blvd
Columbia, MD 21045-4794

Mailing address

8894 Stanford Blvd
Columbia, MD 21045-4794

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

LicenseStateTypeSpecialty
LGP13378MDMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1688947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688947200000",
    "number": "1629756606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8894 STANFORD BLVD",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210454794",
            "fax_number": "347-903-6927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8894 STANFORD BLVD",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210454794",
            "telephone_number": "443-718-0059",
            "fax_number": "347-903-6927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZICK",
        "first_name": "CHARLES",
        "middle_name": "MATTHEW",
        "credential": "LGPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-10",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "LGP13378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2023; 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.