Individual provider Active NPI

Tatiana H Rodriguez Vrem, LCPC, LCADC, NCC,ACS

  • Professional Counselor
  • White Plains, MD
National Provider Identifier
1669759254
Registry record updated Jan 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LC1917 Issued in MD
Practice address
10665 Stanhaven PL
Suite 3109
White Plains, MD 20695-3055
Phone
(301) 538-3899
NPI assigned
Nov 9, 2011
Last updated
Jan 24, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X LCA1813 MD
Professional Counselor 101YP2500X LC1917 MD Primary

Addresses

Primary practice location

10665 Stanhaven PL
Suite 3109
White Plains, MD 20695-3055

Mailing address

10665 Stanhaven Place
Suite 3109
White Plains, MD 20695
Phone (301) 538-3899

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240829000888 MD Practitioner - Mental Health Counselor 0345789715 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

603 Post Office Rd
Suite 210
Waldorf, MD 20602-1914
Phone (301) 705-7593

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCA1813MDMDAddiction (Substance Use Disorder) Counselor
LC1917MDMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Center for Mental Health & Human Relations LLC CurrentSince Aug 19, 2024 Accepting new patients

Locations

603 Post Office Rd
Ste 210
Waldorf, MD 20602
Phone (301) 705-7593

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1320796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358985600000",
    "number": "1669759254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10665 STANHAVEN PLACE",
            "address_2": "SUITE 3109",
            "city": "WHITE PLAINS",
            "state": "MD",
            "postal_code": "20695",
            "telephone_number": "301-538-3899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10665 STANHAVEN PL",
            "address_2": "SUITE 3109",
            "city": "WHITE PLAINS",
            "state": "MD",
            "postal_code": "206953055",
            "telephone_number": "301-538-3899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ VREM",
        "first_name": "TATIANA",
        "middle_name": "H",
        "credential": "LCPC, LCADC, NCC,ACS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-09",
        "last_updated": "2013-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MD",
            "license": "LCA1813",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LC1917",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in White Plains, MD

Sources for this page

Verify at the official NPI Registry.