NPIMap

Organization Active NPI

South County Addiction Clinic

  • Methadone Clinic
  • Annapolis, MD
National Provider Identifier
1801247374
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Methadone ClinicTaxonomy code 261QM2800X
Legal business name
SOUTH COUNTY ADDICTION CLINIC
Practice address
839 Bestgate Road
Suite 300
Annapolis, MD 21401
Phone
(410) 222-6001
Fax
(410) 222-2113
NPI assigned
Jun 27, 2016
Organization subpart
Yes
Parent organization
ANNE ARUNDEL COUNTY DEPARTMENT OF HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Vickey Richardson, R.N.
Title
Co-Program Manager
Phone
(410) 222-6001

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Methadone Clinic 261QM2800X Primary

Addresses

Primary practice location

839 Bestgate Road
Suite 300
Annapolis, MD 21401

Mailing address

839 Bestgate Road
Suite 300
Annapolis, MD 21401
Phone (410) 222-6001

Other identifiers 1

IdentifierTypeStateIssuer
750171400MedicaidMD

National Provider Directory

National Provider Directory
Tax ID family
Adolsecent Family Svcsaddictions29 organizations share this tax ID, including this one
Part of
Adolsecent Family Svcsaddictions

Other organizations with this tax ID 28

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

View all 28

Locations

839 Bestgate Rd
Ste 300
Annapolis, MD 21401
Phone (410) 222-6001

NPI Registry JSON

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

{
    "created_epoch": "1466985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1801247374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "839 BESTGATE ROAD",
            "address_2": "SUITE 300",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "21401",
            "telephone_number": "410-222-6001",
            "fax_number": "410-222-2113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "839 BESTGATE ROAD",
            "address_2": "SUITE 300",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "21401",
            "telephone_number": "410-222-6001",
            "fax_number": "410-222-2113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH COUNTY ADDICTION CLINIC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ANNE ARUNDEL COUNTY DEPARTMENT OF HEALTH",
        "enumeration_date": "2016-06-27",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "RICHARDSON",
        "authorized_official_first_name": "VICKEY",
        "authorized_official_title_or_position": "CO-PROGRAM MANAGER",
        "authorized_official_telephone_number": "410-222-6001",
        "authorized_official_credential": "R.N."
    },
    "taxonomies": [
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "750171400",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Annapolis, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.