NPIMap

Individual provider Active NPI

Chaunna Thomas, LCPC

  • Community/Behavioral Health Agency
  • Edgewood, MD
National Provider Identifier
1699040717
Registry record updated Feb 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
MH- 1044, MH-1043 Issued in MD
Practice address
500 Edgewood Rd Ste 210
Edgewood, MD 21040-2734
Phone
(443) 402-0172
NPI assigned
Mar 22, 2012
Last updated
Feb 20, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 20, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LC8470 MD
Community/Behavioral Health Agency 251S00000X MH- 1044, MH-1043 MD Primary

Addresses

Primary practice location

500 Edgewood Rd Ste 210
Edgewood, MD 21040-2734

Mailing address

500 Edgewood Rd Ste 210
Edgewood, MD 21040-2734
Phone (443) 402-0172

Other identifiers 1

IdentifierTypeStateIssuer
4210018OtherMDMEDICAID PROVIDER NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LC8470MDMDProfessional Counselor
MH- 1044, MH-1043MDMDCommunity/Behavioral Health Agency

Practice roles

OrganizationSpecialtyStatusNew patients
Changing Turns With Team LLC Single Specialty Past Accepting new patients

Organizations & group practices 17

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.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1332374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519084800000",
    "number": "1699040717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 EDGEWOOD RD STE 210",
            "city": "EDGEWOOD",
            "state": "MD",
            "postal_code": "210402734",
            "telephone_number": "443-402-0172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 EDGEWOOD RD STE 210",
            "city": "EDGEWOOD",
            "state": "MD",
            "postal_code": "210402734",
            "telephone_number": "443-402-0172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "CHAUNNA",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-22",
        "last_updated": "2018-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LC8470",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MD",
            "license": "MH- 1044, MH-1043",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID PROVIDER NUMBER",
            "identifier": "4210018",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edgewood, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2018; 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.