Restorative Counseling and Wellness Center LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

RESTORATIVE COUNSELING AND WELLNESS CENTER LLC

Practice address

5058 Dorsey Hall Dr
Suite 103
Ellicott City, MD 21042-7849

Phone

(443) 300-6555

Fax

(443) 288-4582

NPI assigned

Sep 16, 2016

Organization subpart

No

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

Authorized official

Name

Nicole Dechirico, LCSW-C

Title

Social Worker/Owner

Phone

(443) 300-6555

Specialties & licenses 2

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Derek Kevin Cooper, LMHC, LCPC

  • Mental Health Counselor
  • Edmonds, WA
  • NPI 1568005130
  NPD (past)

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

{
    "created_epoch": "1473984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473984000000",
    "number": "1730637984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5058 DORSEY HALL DR",
            "address_2": "SUITE 103",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210427849",
            "telephone_number": "443-300-6555",
            "fax_number": "443-288-4582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5058 DORSEY HALL DR",
            "address_2": "SUITE 103",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210427849",
            "telephone_number": "443-300-6555",
            "fax_number": "443-288-4582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESTORATIVE COUNSELING AND WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-16",
        "last_updated": "2016-09-16",
        "status": "A",
        "authorized_official_last_name": "DECHIRICO",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "SOCIAL WORKER/OWNER",
        "authorized_official_telephone_number": "443-300-6555",
        "authorized_official_credential": "LCSW-C"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Ellicott City, MD
• Providers in Ellicott City, MD by specialty
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2016; 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.