NPIMap

Organization Active NPI

Operation Warrior Refuge, Inc

  • Clinical Neuropsychologist
  • Hollywood, MD
National Provider Identifier
1710357447
Registry record updated Oct 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
05590 Issued in MD
Legal business name
OPERATION WARRIOR REFUGE, INC
Practice address
25420 Rosedale Manor LN
Hollywood, MD 20636-2925
Phone
(301) 880-0531
NPI assigned
Oct 7, 2015
Last updated
Oct 7, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2015

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

Authorized official

Name
Julia Devine, LCPCNPI 1457507899
Title
Therapist
Phone
(240) 298-6680

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LC5662 MD
Clinical Neuropsychologist 103G00000X 05590 MD Primary
Community/Behavioral Health Agency 251S00000X LC5662 MD

Addresses

Primary practice location

25420 Rosedale Manor LN
Hollywood, MD 20636-2925

Mailing address

PO Box 733
Great Mills, MD 20634-0733
Phone (301) 880-0531

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1444176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444176000000",
    "number": "1710357447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 733",
            "city": "GREAT MILLS",
            "state": "MD",
            "postal_code": "206340733",
            "telephone_number": "301-880-0531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25420 ROSEDALE MANOR LN",
            "city": "HOLLYWOOD",
            "state": "MD",
            "postal_code": "206362925",
            "telephone_number": "301-880-0531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPERATION WARRIOR REFUGE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-07",
        "last_updated": "2015-10-07",
        "status": "A",
        "authorized_official_last_name": "DEVINE",
        "authorized_official_first_name": "JULIA",
        "authorized_official_title_or_position": "THERAPIST",
        "authorized_official_telephone_number": "240-298-6680",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "LC5662",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "MD",
            "license": "05590",
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MD",
            "license": "LC5662",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2015; 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.