Collaborative Concepts of Maryland

Key facts

NPI

1861968489

Entity type

Organization (NPI type 2)

Primary specialty

Clinical Social Worker 1041C0700X

Legal business name

COLLABORATIVE CONCEPTS OF MARYLAND

Practice address

1400 Mercantile Lane, Suite 208
Largo, MD 20774

Phone

(301) 318-1148

NPI assigned

Oct 22, 2018

Organization subpart

No

Authorized official

Name

Dr. Shirley R. Newton-Guest, LCSW-C

Title

Licensed Certified Social Worker-CL

Phone

(301) 318-1148

Corporate family (same tax ID) 1

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

• Collaborative Concepts of Maryland, LLC Community/Behavioral Health Agency · Baltimore, MD · NPI 1699182782
  NPD tax ID

National Provider Directory

Tax ID family

Collaborative Concepts of Maryland (2 organizations share this tax ID)

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Oct 22, 2018.

{
    "created_epoch": "1540166400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540166400000",
    "number": "1861968489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 MERCANTILE LANE, SUITE 208",
            "city": "LARGO",
            "state": "MD",
            "postal_code": "20774",
            "telephone_number": "301-318-1148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 MERCANTILE LANE, SUITE 208",
            "city": "LARGO",
            "state": "MD",
            "postal_code": "20774",
            "telephone_number": "301-318-1148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLABORATIVE CONCEPTS OF MARYLAND",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-22",
        "last_updated": "2018-10-22",
        "status": "A",
        "authorized_official_last_name": "NEWTON-GUEST",
        "authorized_official_first_name": "SHIRLEY",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "LICENSED CERTIFIED SOCIAL WORKER-CL",
        "authorized_official_telephone_number": "301-318-1148",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "LCSW-C"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "062835200",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "512512000",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Largo, MD

• Alexis Cleary, CRNA
• Client Business Services & Associates LLC
• Vaylah B Clinton, ED.D, LCPC
• Temeka Coates, MSN, APRN, FNP-BC
• Olumide A Coker, M.D.
• Adrienne G Collier, MD
• Collins Consulting, LLC
• Committed to the Journey LLC
• Community Counseling & Mentoring Services, Inc
• Community Counseling & Mentoring Services, Inc

All providers in Largo, MD · Clinical Social Worker in Maryland