NPIMap

Organization Active NPI

Pyramid Walden, LLC

  • Addiction (Substance Use Disorder) Counselor
  • California, MD
National Provider Identifier
1659603322
Registry record updated Apr 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Legal business name
PYRAMID WALDEN, LLC
Practice address
44867 St. Andrews Church Road
California, MD 20619
Phone
(301) 997-1300
Fax
(301) 863-3368
NPI assigned
Feb 5, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2024

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

Authorized official

Name
Jason Hendricks
Title
Chief Executive Officer
Phone
(814) 940-0407

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X Primary

Addresses

Primary practice location

44867 St. Andrews Church Road
California, MD 20619

Mailing address

30007 Business Center Dr
Charlotte Hall, MD 20622-3101
Phone (301) 997-1300

Other identifiers 2

IdentifierTypeStateIssuer
7800355-01MedicaidMD
745188101MedicaidMD

National Provider Directory

National Provider Directory
Tax ID family
Pyramid Walden LLC18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1265328000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712707200000",
    "number": "1659603322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30007 BUSINESS CENTER DR",
            "city": "CHARLOTTE HALL",
            "state": "MD",
            "postal_code": "206223101",
            "telephone_number": "301-997-1300",
            "fax_number": "301-997-1321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44867 ST. ANDREWS CHURCH ROAD",
            "city": "CALIFORNIA",
            "state": "MD",
            "postal_code": "20619",
            "telephone_number": "301-997-1300",
            "fax_number": "301-863-3368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PYRAMID WALDEN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-05",
        "last_updated": "2024-04-10",
        "certification_date": "2024-04-10",
        "status": "A",
        "authorized_official_last_name": "HENDRICKS",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "814-940-0407"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7800355-01",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "745188101",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in California, MD

Sources for this page

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