NPIMap

Organization Active NPI

Outreach Recovery II

  • Mental Health Counselor
  • Prince Frederick, MD
National Provider Identifier
1871257964
Registry record updated Jul 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
OUTREACH RECOVERY II
Practice address
110 Hospital Rd Ste 306
Prince Frederick, MD 20678-4046
Phone
(410) 800-4466
NPI assigned
Oct 26, 2021
Last updated
Jul 31, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2024

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

Authorized official

Name
Ginny Hayden
Title
Licensing Manager
Phone
(240) 728-5864

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

110 Hospital Rd Ste 306
Prince Frederick, MD 20678-4046

Mailing address

14205 Park Center Dr # 201202
Laurel, MD 20707-5246
Phone (410) 800-4466

Other identifiers 1

IdentifierTypeStateIssuer
77779730MedicaidMD

National Provider Directory

National Provider Directory
Tax ID family
Outreach Recovery II LLC29 organizations share this tax ID, including this one

Other organizations with this tax ID 28

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

View all 28

Locations

14205 Park Center Dr
Ste 104
Laurel, MD 20707

301 Steeple Chase Dr
Ste 106
Prince Frederick, MD 20678

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1635206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722384000000",
    "number": "1871257964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14205 PARK CENTER DR # 201202",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207075246",
            "telephone_number": "410-800-4466",
            "fax_number": "410-705-5024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 HOSPITAL RD STE 306",
            "city": "PRINCE FREDERICK",
            "state": "MD",
            "postal_code": "206784046",
            "telephone_number": "410-800-4466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OUTREACH RECOVERY II",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-26",
        "last_updated": "2024-07-31",
        "certification_date": "2024-07-31",
        "status": "A",
        "authorized_official_last_name": "HAYDEN",
        "authorized_official_first_name": "GINNY",
        "authorized_official_title_or_position": "LICENSING MANAGER",
        "authorized_official_telephone_number": "240-728-5864"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "77779730",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Prince Frederick, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2024; 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.