NPIMap

Organization Active NPI

Mountain Lake Associates, LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Bethesda, MD
National Provider Identifier
1679195358
Registry record updated May 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
MOUNTAIN LAKE ASSOCIATES, LLC
Practice address
6725 Honesty Dr
Bethesda, MD 20817-5516
Phone
(202) 739-1784
NPI assigned
May 15, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2020

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

Authorized official

Name
William Scott Gould, ED.D.
Title
Ceo
Phone
(202) 739-1784

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary

Addresses

Primary practice location

6725 Honesty Dr
Bethesda, MD 20817-5516

Mailing address

6725 Honesty Dr
Bethesda, MD 20817-5516
Phone (202) 739-1784

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1589500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589500800000",
    "number": "1679195358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6725 HONESTY DR",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208175516",
            "telephone_number": "202-739-1784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6725 HONESTY DR",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208175516",
            "telephone_number": "202-739-1784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN LAKE ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-15",
        "last_updated": "2020-05-15",
        "certification_date": "2020-05-15",
        "status": "A",
        "authorized_official_last_name": "GOULD",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "202-739-1784",
        "authorized_official_credential": "ED.D."
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethesda, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2020; 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.