NPIMap

Organization Active NPI

Carroll County Youth Service Bureau, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Westminster, MD
National Provider Identifier
1679860381
Registry record updated Feb 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
904243 Issued in MD
Legal business name
CARROLL COUNTY YOUTH SERVICE BUREAU, INC.
Practice address
59 Kate Wagner Rd
Westminster, MD 21157-6957
Phone
(410) 848-2500
Fax
(410) 876-3016
NPI assigned
Jul 1, 2011
Last updated
Feb 15, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2023

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

Authorized official

Name
Lynn Davis, LCPCNPI 1467579458
Title
Executive Director
Phone
(443) 244-8649

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 904243 MD Primary

Addresses

Primary practice location

59 Kate Wagner Rd
Westminster, MD 21157-6957

Mailing address

59 Kate Wagner Rd
Westminster, MD 21157-6957
Phone (410) 848-2500

Other identifiers 1

IdentifierTypeStateIssuer
420658400MedicaidMD

National Provider Directory

National Provider Directory
Tax ID family
Carroll County Youth Service Bureau Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1309478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676419200000",
    "number": "1679860381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "59 KATE WAGNER RD",
            "city": "WESTMINSTER",
            "state": "MD",
            "postal_code": "211576957",
            "telephone_number": "410-848-2500",
            "fax_number": "410-876-3016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "59 KATE WAGNER RD",
            "city": "WESTMINSTER",
            "state": "MD",
            "postal_code": "211576957",
            "telephone_number": "410-848-2500",
            "fax_number": "410-876-3016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARROLL COUNTY YOUTH SERVICE BUREAU, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-01",
        "last_updated": "2023-02-15",
        "certification_date": "2023-02-15",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "LYNN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "443-244-8649",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "MD",
            "license": "904243",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "420658400",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Westminster, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2023; 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.