NPIMap

Organization Active NPI

Issaiah House Inc

  • Professional Counselor
  • Baltimore, MD
National Provider Identifier
1891278024
Registry record updated May 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
ISSAIAH HOUSE INC
Practice address
3808 Eastern Ave
Baltimore, MD 21224-4221
Phone
(443) 882-1943
NPI assigned
Sep 13, 2018
Organization subpart
Yes
Parent organization
ISSAIAH HOUSE INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 18, 2021

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

Authorized official

Name
Mr. Darryl Edward Braxton, LCPC, LCADC
Title
Owner
Phone
(443) 882-1943

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X Primary

Addresses

Primary practice location

3808 Eastern Ave
Baltimore, MD 21224-4221

Mailing address

919 Calwell Rd
Baltimore, MD 21229-5006
Phone (144) 388-2194

Other practice location 1

1705 Edmondson Ave
Baltimore, MD 21223-1222
Phone (443) 882-1943

Other practice location 2

17 Warren Rd Ste 20B
Baltimore, MD 21208-5334
Phone (443) 882-1943

Other identifiers 1

IdentifierTypeStateIssuer
250016700MedicaidMD

National Provider Directory

National Provider Directory
Tax ID family
Issaiah House Inc4 organizations share this tax ID, including this one
Part of
Issaiah House Inc

Other organizations with this tax ID 3

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": "1536796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621296000000",
    "number": "1891278024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "919 CALWELL RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212295006",
            "telephone_number": "144-388-2194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3808 EASTERN AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212244221",
            "telephone_number": "443-882-1943"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1705 Edmondson Ave",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212231222",
            "country_code": "US",
            "telephone_number": "443-882-1943",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "17 Warren Rd Ste 20B",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212085334",
            "country_code": "US",
            "telephone_number": "443-882-1943",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ISSAIAH HOUSE INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ISSAIAH HOUSE INC",
        "enumeration_date": "2018-09-13",
        "last_updated": "2021-05-18",
        "certification_date": "2021-05-18",
        "status": "A",
        "authorized_official_last_name": "BRAXTON",
        "authorized_official_first_name": "DARRYL",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "443-882-1943",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCPC, LCADC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "250016700",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2021; 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.