Fresh Start Therapeutic Services, LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

FRESH START THERAPEUTIC SERVICES, LLC

Practice address

626 Towne Center Dr Ste 204
Joppa, MD 21085-4451

Phone

(443) 313-3241

NPI assigned

Aug 30, 2022

Last updated

Aug 30, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tekora NicholsNPI 1609264449

Title

Clinical Manager

Phone

(240) 370-9479

Specialties & licenses 1

Addresses

Electronic endpoints 1

Tax ID family

Fresh Start Therapeutic Services2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Fresh Start Therapeutic Services, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Joppa, MD
  • NPI 1437767852
  NPD tax ID

Locations

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.

• Tekora Nichols, LCSW-C

  • Clinical Social Worker
  • Belcamp, MD
  • NPI 1609264449
  NPD Authorized official

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

{
    "created_epoch": "1661817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661817600000",
    "number": "1730809732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "626 TOWNE CENTER DR STE 204",
            "city": "JOPPA",
            "state": "MD",
            "postal_code": "210854451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "626 TOWNE CENTER DR STE 204",
            "city": "JOPPA",
            "state": "MD",
            "postal_code": "210854451",
            "telephone_number": "443-313-3241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRESH START THERAPEUTIC SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-30",
        "last_updated": "2022-08-30",
        "certification_date": "2022-08-23",
        "status": "A",
        "authorized_official_last_name": "NICHOLS",
        "authorized_official_first_name": "TEKORA",
        "authorized_official_title_or_position": "CLINICAL MANAGER",
        "authorized_official_telephone_number": "240-370-9479"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "freshstarttherapy@outlook.com",
            "affiliation": "N",
            "address_1": "626 Towne Center Dr Ste 204",
            "city": "Joppa",
            "state": "MD",
            "country_code": "US",
            "postal_code": "210854451",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sandra N Ferguson, FNP-BC
• Finepoints Private Duty Healthcare, LLC
• Patsy N. Firth, M.D.
• Mary Kate Fischer
• Fresh Start Therapeutic Services, LLC
• Marlene S Gearing, PHYSICAL THERAPIST
• Elizabeth Gill, LCSW-C
• Golden Days Homecare, LLC
• Good Morning Health Care
• Dianne Goodman, LCSW-C

• Mental Health Clinic/Center (Including Community Mental Health Center) in Joppa, MD
• Providers in Joppa, MD by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2022; 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.