NPIMap

Organization Active NPI

Free Baltimore, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Baltimore, MD
National Provider Identifier
1639758337
Registry record updated Oct 19, 2024
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
FREE BALTIMORE, LLC
Practice address
1120 N Charles St Ste 408
Baltimore, MD 21201-5594
Phone
(443) 416-5667
Fax
(443) 687-8720
NPI assigned
Apr 8, 2021
Organization subpart
Yes
Parent organization
FREE BALTIMORE, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 19, 2024

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

Authorized official

Name
Northwest Registered Agent
Title
Re
Phone
(443) 416-5667

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

1120 N Charles St Ste 408
Baltimore, MD 21201-5594

Mailing address

1120 N Charles St Ste 408
Baltimore, MD 21201-5594
Phone (443) 416-5667

Other practice location 1

3261 Old Washington Rd
Waldorf, MD 20602-3223
Phone (240) 229-6417

Other names 1

  • Wholistic Behavior Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Free Baltimore LLC9 organizations share this tax ID, including this one
Part of
Free Baltimore LLC

Other organizations with this tax ID 8

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

Locations

1120 N Charles St
Ste 408
Baltimore, MD 21201
Phone (443) 416-5667

NPI Registry JSON

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

{
    "created_epoch": "1617840000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729296000000",
    "number": "1639758337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 N CHARLES ST STE 408",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212015594",
            "telephone_number": "443-416-5667",
            "fax_number": "443-687-8720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 N CHARLES ST STE 408",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212015594",
            "telephone_number": "443-416-5667",
            "fax_number": "443-687-8720"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3261 Old Washington Rd",
            "address_purpose": "LOCATION",
            "city": "Waldorf",
            "state": "MD",
            "postal_code": "206023223",
            "country_code": "US",
            "telephone_number": "240-229-6417",
            "fax_number": "443-687-7820",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FREE BALTIMORE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FREE BALTIMORE, LLC",
        "enumeration_date": "2021-04-08",
        "last_updated": "2024-10-19",
        "certification_date": "2024-10-19",
        "status": "A",
        "authorized_official_last_name": "AGENT",
        "authorized_official_first_name": "NORTHWEST",
        "authorized_official_middle_name": "REGISTERED",
        "authorized_official_title_or_position": "RE",
        "authorized_official_telephone_number": "443-416-5667"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wholistic Behavior",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Oct 19, 2024; 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.