Active NPI
Wayne Clemons
- Addiction (Substance Use Disorder) Counselor
- Reisterstown, MD
National Provider Identifier
1760806749
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- LCA012
- Practice address
- 100 Owings CT Ste 8
Reisterstown, MD 21136-3045 - Phone
- (410) 526-7100
- NPI assigned
- Feb 11, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | LCA012 | MD | Primary |
Addresses
Primary practice location
100 Owings CT Ste 8
Reisterstown, MD 21136-3045
Mailing address
100 Owings CT Suite 8
Reistertown, MD 21136
Phone (410) 526-7100
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCA012 | MD | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1392076800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1392076800000",
"number": "1760806749",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 OWINGS CT SUITE 8",
"city": "REISTERTOWN",
"state": "MD",
"postal_code": "21136",
"telephone_number": "410-526-7100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 OWINGS CT STE 8",
"city": "REISTERSTOWN",
"state": "MD",
"postal_code": "211363045",
"telephone_number": "410-526-7100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLEMONS",
"first_name": "WAYNE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-02-11",
"last_updated": "2014-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "MD",
"license": "LCA012",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Reisterstown, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.