Active NPI
Doreatha Kurtz
- Addiction (Substance Use Disorder) Counselor
- Upper Marlboro, MD
National Provider Identifier
1881002004
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- AC0518
- Practice address
- 14701 Governor Oden Bowie Dr
Room 4416
Upper Marlboro, MD 20772-3046 - Phone
- (301) 780-7870
- NPI assigned
- Jul 31, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | AC0518 | MD | Primary |
Addresses
Primary practice location
14701 Governor Oden Bowie Dr
Room 4416
Upper Marlboro, MD 20772-3046
Mailing address
14701 Governor Oden Bowie Dr
Room 4416
Upper Marlboro, MD 20772-3046
Phone (301) 780-7870
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AC0518 | MD | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1406764800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1406764800000",
"number": "1881002004",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14701 GOVERNOR ODEN BOWIE DR",
"address_2": "ROOM 4416",
"city": "UPPER MARLBORO",
"state": "MD",
"postal_code": "207723046",
"telephone_number": "301-780-7870"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14701 GOVERNOR ODEN BOWIE DR",
"address_2": "ROOM 4416",
"city": "UPPER MARLBORO",
"state": "MD",
"postal_code": "207723046",
"telephone_number": "301-780-7870"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KURTZ",
"first_name": "DOREATHA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-07-31",
"last_updated": "2014-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "MD",
"license": "AC0518",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Upper Marlboro, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.