NPIMap

Organization Active NPI

Suburban Pastoral Counsleing Center

  • Professional Counselor
  • Catonsville, MD
National Provider Identifier
1760838569
Registry record updated May 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LC6983 Issued in MD
Legal business name
SUBURBAN PASTORAL COUNSLEING CENTER
Practice address
2 W. Rolling Crossroads Ste 209
Catonsville, MD 21228-6209
Phone
(410) 719-0086
Fax
(443) 251-2664
NPI assigned
May 11, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 11, 2016

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

Authorized official

Name
Dr. Elaine M Bain, PH.D.; LCPC
Title
Executive /Clinical Director
Phone
(410) 719-0086

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X LC6983 MD Primary

Addresses

Primary practice location

2 W. Rolling Crossroads Ste 209
Catonsville, MD 21228-6209

Mailing address

PO Box 3274
Catonsville, MD 21228-0274
Phone (410) 719-0086

Other identifiers 1

IdentifierTypeStateIssuer
LC6983OtherMDLICENSED PROFESSIONAL CLINICAL COUNSELOR

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

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

NPI Registry JSON

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

{
    "created_epoch": "1462924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462924800000",
    "number": "1760838569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3274",
            "city": "CATONSVILLE",
            "state": "MD",
            "postal_code": "212280274",
            "telephone_number": "410-719-0086",
            "fax_number": "443-251-2664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 W. ROLLING CROSSROADS STE 209",
            "city": "CATONSVILLE",
            "state": "MD",
            "postal_code": "212286209",
            "telephone_number": "410-719-0086",
            "fax_number": "443-251-2664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUBURBAN PASTORAL COUNSLEING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-11",
        "last_updated": "2016-05-11",
        "status": "A",
        "authorized_official_last_name": "BAIN",
        "authorized_official_first_name": "ELAINE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "EXECUTIVE /CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "410-719-0086",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D.; LCPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LC6983",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED PROFESSIONAL CLINICAL COUNSELOR",
            "identifier": "LC6983",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Catonsville, MD

Sources for this page

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