NPIMap

Organization Active NPI

Community Counseling & Mentoring Services, Inc

  • Counseling Psychologist
  • Largo, MD
National Provider Identifier
1801823455
Registry record updated Dec 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
13039 Issued in MD
Legal business name
COMMUNITY COUNSELING & MENTORING SERVICES, INC
Practice address
1300 Mercantile LN
Suite 208
Largo, MD 20774-5327
Phone
(301) 583-0001
Fax
(301) 583-3403
NPI assigned
Jun 27, 2006
Last updated
Dec 21, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2016

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

Authorized official

Name
Mr. Anthony Carvana Sr.
Title
President & Ceo
Phone
(301) 583-0001

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X 13039 MD Primary

Addresses

Primary practice location

1300 Mercantile LN
Suite 208
Largo, MD 20774-5327

Mailing address

1300 Mercantile LN
Suite 208
Largo, MD 20774-5327
Phone (301) 583-0001

National Provider Directory

National Provider Directory
Tax ID family
Community Counseling Mentoring Services Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

1300 Mercantile Ln
Ste 208
Upper Marlboro, MD 20774
Phone (301) 563-0001

NPI Registry JSON

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482278400000",
    "number": "1801823455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 MERCANTILE LN",
            "address_2": "SUITE 208",
            "city": "LARGO",
            "state": "MD",
            "postal_code": "207745327",
            "telephone_number": "301-583-0001",
            "fax_number": "301-583-3403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 MERCANTILE LN",
            "address_2": "SUITE 208",
            "city": "LARGO",
            "state": "MD",
            "postal_code": "207745327",
            "telephone_number": "301-583-0001",
            "fax_number": "301-583-3403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY COUNSELING & MENTORING SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-27",
        "last_updated": "2016-12-21",
        "status": "A",
        "authorized_official_last_name": "CARVANA",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "301-583-0001",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr."
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "MD",
            "license": "13039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Largo, MD

Sources for this page

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