Breakwater Counseling, LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

BREAKWATER COUNSELING, LLC

Practice address

5643 Chelwynd Rd
Halethorpe, MD 21227-3807

Phone

(410) 733-4702

NPI assigned

Nov 18, 2020

Last updated

Nov 18, 2020By 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

Christina Foerster Puglisi, LCSW-C

Title

Clinical Social Worker/Owner

Phone

(410) 733-4702

Specialties & licenses 1

Addresses

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.

• Christina Puglisi, LCSW-C

  • Clinical Social Worker
  • Baltimore, MD
  • NPI 1194157255
  NPD

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

{
    "created_epoch": "1605657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605657600000",
    "number": "1881297174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5643 CHELWYND RD",
            "city": "HALETHORPE",
            "state": "MD",
            "postal_code": "212273807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5643 CHELWYND RD",
            "city": "HALETHORPE",
            "state": "MD",
            "postal_code": "212273807",
            "telephone_number": "410-733-4702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BREAKWATER COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-18",
        "last_updated": "2020-11-18",
        "certification_date": "2020-11-18",
        "status": "A",
        "authorized_official_last_name": "FOERSTER PUGLISI",
        "authorized_official_first_name": "CHRISTINA",
        "authorized_official_title_or_position": "CLINICAL SOCIAL WORKER/OWNER",
        "authorized_official_telephone_number": "410-733-4702",
        "authorized_official_credential": "LCSW-C"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Hannah Broadwater, D.P.T.

• Mental Health Clinic/Center (Including Community Mental Health Center) in Halethorpe, MD
• Providers in Halethorpe, MD by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2020; 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.