NPIMap

Organization Active NPI

Nautical Breeze Therapy, LLC

  • Marriage & Family Therapist
  • Easton, MD
National Provider Identifier
1861153926
Registry record updated Dec 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Legal business name
NAUTICAL BREEZE THERAPY, LLC
Practice address
29626 Old Creek LN
Easton, MD 21601-7929
Phone
(301) 331-1664
NPI assigned
Dec 31, 2021
Last updated
Dec 10, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2023

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

Authorized official

Name
Shannon Holmes, LCMFTNPI 1891271979
Title
LMFT
Phone
(301) 331-1664

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X NU Primary

Addresses

Primary practice location

29626 Old Creek LN
Easton, MD 21601-7929

Mailing address

29626 Old Creek LN
Easton, MD 21601-7929
Phone (301) 331-1664

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1640908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702166400000",
    "number": "1861153926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29626 OLD CREEK LN",
            "city": "EASTON",
            "state": "MD",
            "postal_code": "216017929",
            "telephone_number": "301-331-1664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29626 OLD CREEK LN",
            "city": "EASTON",
            "state": "MD",
            "postal_code": "216017929",
            "telephone_number": "301-331-1664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NAUTICAL BREEZE THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-31",
        "last_updated": "2023-12-10",
        "certification_date": "2023-12-10",
        "status": "A",
        "authorized_official_last_name": "HOLMES",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_title_or_position": "LMFT",
        "authorized_official_telephone_number": "301-331-1664",
        "authorized_official_credential": "LCMFT"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Easton, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2023; 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.