The Authentic Corner, LLC

Primary specialty

CounselorTaxonomy code 101Y00000X

Legal business name

THE AUTHENTIC CORNER, LLC

Practice address

1341 Hill Born Dr
Hanover, MD 21076-1174

Phone

(410) 774-5120

NPI assigned

Sep 25, 2024

Organization subpart

No

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

Authorized official

Name

Deja' Moses, LCPCNPI 1104410943

Title

Ceo

Phone

(410) 774-5120

Specialties & licenses 3

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Deja' Moses

  • Professional Counselor
  • Towson, MD
  • NPI 1104410943

  Mental Health

  NPD Authorized official

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

{
    "created_epoch": "1727222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727222400000",
    "number": "1669299194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1341 HILL BORN DR",
            "city": "HANOVER",
            "state": "MD",
            "postal_code": "210761174",
            "telephone_number": "443-942-2843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1341 HILL BORN DR",
            "city": "HANOVER",
            "state": "MD",
            "postal_code": "210761174",
            "telephone_number": "410-774-5120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE AUTHENTIC CORNER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-25",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A",
        "authorized_official_last_name": "MOSES",
        "authorized_official_first_name": "DEJA'",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "410-774-5120",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Counselor in Hanover, MD
• Providers in Hanover, MD by specialty
• Counselor in Maryland

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