Organization Active NPI

Little Island Counseling and Wellness, LLC

  • Adult Mental Health Clinic/Center
  • Frederick, MD
National Provider Identifier
1790446037
Registry record updated Nov 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
LITTLE ISLAND COUNSELING AND WELLNESS, LLC
Practice address
5100 Buckeystown Pike Ste 250
Frederick, MD 21704-8344
Phone
(910) 367-5355
NPI assigned
Jan 9, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2024

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

Authorized official

Name
Mrs. Amber Norville, LCSW-CNPI 1114577137
Title
Owner
Phone
(910) 367-5355

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Adult Mental Health Clinic/Center 261QM0850X Primary

Addresses

Primary practice location

5100 Buckeystown Pike Ste 250
Frederick, MD 21704-8344

Mailing address

5100 Buckeystown Pike Ste 250
Frederick, MD 21704-8344
Phone (910) 367-5355

Other identifiers 1

IdentifierTypeStateIssuer
1114577137OtherNPI 1

National Provider Directory

National Provider Directory

Locations

102 Elizabeth St
Ste B
Jacksonville, NC 28540

226 N Front St
Ste 157
Wilmington, NC 28401

Practitioners & affiliated clinicians

Practitioners 2

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": "1641686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731715200000",
    "number": "1790446037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5100 BUCKEYSTOWN PIKE STE 250",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217048344",
            "telephone_number": "910-367-5355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 BUCKEYSTOWN PIKE STE 250",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217048344",
            "telephone_number": "910-367-5355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LITTLE ISLAND COUNSELING AND WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-09",
        "last_updated": "2024-11-16",
        "certification_date": "2024-11-16",
        "status": "A",
        "authorized_official_last_name": "NORVILLE",
        "authorized_official_first_name": "AMBER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "910-367-5355",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW-C"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI 1",
            "identifier": "1114577137",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2024; 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.