NPIMap

Organization Active NPI

Brook Lane Health Services/Laurel Hall

  • School Counselor
  • Hagerstown, MD
National Provider Identifier
1891185658
Registry record updated Feb 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
School CounselorTaxonomy code 101YS0200X
License
3852 Issued in MD
Legal business name
BROOK LANE HEALTH SERVICES/LAUREL HALL
Practice address
13310-A Brook Lane
Hagerstown, MD 21742-1514
Phone
(301) 733-0330
Fax
(301) 733-4038
NPI assigned
Feb 2, 2015
Organization subpart
Yes
Parent organization
BROOK LANE HEALTH SERVICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 14, 2017

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

Authorized official

Name
Mrs. Kristy Poffenberger
Title
Coordinator/Managed Care
Phone
(301) 733-0331

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YS0200X 3852 MD Primary

Addresses

Primary practice location

13310-A Brook Lane
Hagerstown, MD 21742-1514

Mailing address

13310-A Brook Lane
Hagerstown, MD 21742-1514
Phone (301) 733-0330

Other identifiers 1

IdentifierTypeStateIssuer
568605900MedicaidMD

Other names 1

  • Laurel Hall School Other name

National Provider Directory

National Provider Directory
Tax ID family
Book Lane House Staff5 organizations share this tax ID, including this one
Part of
Book Lane House Staff

Other organizations with this tax ID 4

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

NPI Registry JSON

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

{
    "created_epoch": "1422835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487030400000",
    "number": "1891185658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13310-A BROOK LANE",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217421514",
            "telephone_number": "301-733-0330",
            "fax_number": "301-733-4038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13310-A BROOK LANE",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217421514",
            "telephone_number": "301-733-0330",
            "fax_number": "301-733-4038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOK LANE HEALTH SERVICES/LAUREL HALL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BROOK LANE HEALTH SERVICES",
        "enumeration_date": "2015-02-02",
        "last_updated": "2017-02-14",
        "status": "A",
        "authorized_official_last_name": "POFFENBERGER",
        "authorized_official_first_name": "KRISTY",
        "authorized_official_title_or_position": "COORDINATOR/MANAGED CARE",
        "authorized_official_telephone_number": "301-733-0331",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "101YS0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, School",
            "state": "MD",
            "license": "3852",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "568605900",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Laurel Hall School",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Hagerstown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2017; 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.