Individual provider Active NPI

Devita Denese Brevard, LCSW-C

  • Mental Health Counselor
  • Baltimore, MD
National Provider Identifier
1649638461
Registry record updated Feb 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
20322 Issued in MD
Practice address
1800 N Charles St
Ste 204
Baltimore, MD 21201-5920
Phone
(443) 386-7537
NPI assigned
Feb 8, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2016

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 20322 MD Primary

Addresses

Primary practice location

1800 N Charles St
Ste 204
Baltimore, MD 21201-5920

Mailing address

1800 N Charles St
Ste 204
Baltimore, MD 21201-5920
Phone (443) 386-7537

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
20322MDMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Atived Counseling Group LLC Current Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1454889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454889600000",
    "number": "1649638461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 N CHARLES ST",
            "address_2": "STE 204",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212015920",
            "telephone_number": "443-386-7537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 N CHARLES ST",
            "address_2": "STE 204",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212015920",
            "telephone_number": "443-386-7537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREVARD",
        "first_name": "DEVITA",
        "middle_name": "DENESE",
        "credential": "LCSW-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-08",
        "last_updated": "2016-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "20322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Feb 8, 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.