NPIMap

Organization Active NPI

Supportive Care of Maryland LLC

  • Clinical Psychologist
  • Elkton, MD
National Provider Identifier
1750970232
Registry record updated Jan 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
SUPPORTIVE CARE OF MARYLAND LLC
Practice address
1 Price Dr
Elkton, MD 21921-6731
Phone
(718) 298-4375
NPI assigned
Jan 11, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2021

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

Authorized official

Name
Raphael Lichtschein
Title
President
Phone
(718) 506-1115

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X Primary

Addresses

Primary practice location

1 Price Dr
Elkton, MD 21921-6731

Mailing address

27 Randolph Rd
Howell, NJ 07731-8611
Phone (718) 298-4375

National Provider Directory

National Provider Directory
Tax ID family
Supportive Care of Maryland LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

NPI Registry JSON

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

{
    "created_epoch": "1610323200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610323200000",
    "number": "1750970232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 RANDOLPH RD",
            "city": "HOWELL",
            "state": "NJ",
            "postal_code": "077318611",
            "telephone_number": "718-298-4375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 PRICE DR",
            "city": "ELKTON",
            "state": "MD",
            "postal_code": "219216731",
            "telephone_number": "718-298-4375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPPORTIVE CARE OF MARYLAND LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-11",
        "last_updated": "2021-01-11",
        "certification_date": "2021-01-11",
        "status": "A",
        "authorized_official_last_name": "LICHTSCHEIN",
        "authorized_official_first_name": "RAPHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-506-1115"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkton, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2021; 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.