NPIMap

Organization Active NPI

Gaudenzia

  • Addiction (Substance Use Disorder) Counselor
  • Severna Park, MD
National Provider Identifier
1740652304
Registry record updated Oct 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Legal business name
GAUDENZIA
Practice address
570 Ritchie Hwy
Suite H
Severna Park, MD 21146-2925
Phone
(410) 975-0067
NPI assigned
Oct 22, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2015

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

Authorized official

Name
Greg Warren, MBA
Title
Regional Director
Phone
(410) 367-5501

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X Primary

Addresses

Primary practice location

570 Ritchie Hwy
Suite H
Severna Park, MD 21146-2925

Mailing address

3643 Woodland Ave
Baltimore, MD 21215-5512
Phone (410) 367-5501

Other identifiers 1

IdentifierTypeStateIssuer
4171233MedicaidMD

National Provider Directory

National Provider Directory
Tax ID family
Gaudenzia Inc77 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 17

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 17

Locations

3643 Woodland Ave
Baltimore, MD 21215
Phone (410) 367-5501

570 Ritchie Hwy
#H
Severna Park, MD 21146

NPI Registry JSON

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

{
    "created_epoch": "1445472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445472000000",
    "number": "1740652304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3643 WOODLAND AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212155512",
            "telephone_number": "410-367-5501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "570 RITCHIE HWY",
            "address_2": "SUITE H",
            "city": "SEVERNA PARK",
            "state": "MD",
            "postal_code": "211462925",
            "telephone_number": "410-975-0067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GAUDENZIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-22",
        "last_updated": "2015-10-22",
        "status": "A",
        "authorized_official_last_name": "WARREN",
        "authorized_official_first_name": "GREG",
        "authorized_official_title_or_position": "REGIONAL DIRECTOR",
        "authorized_official_telephone_number": "410-367-5501",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4171233",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Severna Park, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 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.