J Daniels Psychtherapy Services, Inc

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

03791 Issued in MD

Legal business name

J DANIELS PSYCHTHERAPY SERVICES, INC

Practice address

6798 Amherst Rd
Bryans Road, MD 20616-3046

Phone

(301) 375-9220

NPI assigned

Apr 29, 2015

Last updated

Aug 14, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jennene Daniels, LCSW-CNPI 1669470894

Title

Pres.

Phone

(301) 375-9220

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jennene Daniels, LCSW-C, BCD

  • Clinical Social Worker
  • Waldorf, MD
  • NPI 1669470894
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1430265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439510400000",
    "number": "1811374879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6798 AMHERST RD",
            "city": "BRYANS ROAD",
            "state": "MD",
            "postal_code": "206163046",
            "telephone_number": "301-375-9220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6798 AMHERST RD",
            "city": "BRYANS ROAD",
            "state": "MD",
            "postal_code": "206163046",
            "telephone_number": "301-375-9220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J DANIELS PSYCHTHERAPY SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-29",
        "last_updated": "2015-08-14",
        "status": "A",
        "authorized_official_last_name": "DANIELS",
        "authorized_official_first_name": "JENNENE",
        "authorized_official_title_or_position": "PRES.",
        "authorized_official_telephone_number": "301-375-9220",
        "authorized_official_credential": "LCSW-C"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MD",
            "license": "03791",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BCBS",
            "identifier": "36910005",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI",
            "identifier": "528447",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "582M906F",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "621210700",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "003728",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE/HNFS",
            "identifier": "1669470894",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Bryans Road, MD
• Providers in Bryans Road, MD by specialty
• Community/Behavioral Health Agency in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.