Active NPI
Jaalah-Ai Heughan, LCPC
- Mental Health Counselor
- Pikesville, MD
National Provider Identifier
1891336061
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- LC11919
- Practice address
- 4 Pomona W Apt 10
Pikesville, MD 21208-2950 - Phone
- (410) 900-9064
- NPI assigned
- Sep 30, 2019
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LC11919 | MD | Primary |
Addresses
Primary practice location
4 Pomona W Apt 10
Pikesville, MD 21208-2950
Mailing address
4 Pomona W Apt 10
Pikesville, MD 21208-2950
Other practice location 1
10 W Madison St Ste 11
Baltimore, MD 21201-2313
Phone (443) 438-7863
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | BALTIMORE |
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 |
|---|---|---|---|
| LC11919 | MD | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1569801600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1631836800000",
"number": "1891336061",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4 POMONA W APT 10",
"city": "PIKESVILLE",
"state": "MD",
"postal_code": "212082950"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4 POMONA W APT 10",
"city": "PIKESVILLE",
"state": "MD",
"postal_code": "212082950",
"telephone_number": "410-900-9064"
}
],
"practiceLocations": [
{
"address_1": "10 W Madison St Ste 11",
"address_purpose": "LOCATION",
"city": "Baltimore",
"state": "MD",
"postal_code": "212012313",
"country_code": "US",
"telephone_number": "443-438-7863",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HEUGHAN",
"first_name": "JAALAH-AI",
"credential": "LCPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-09-30",
"last_updated": "2021-09-17",
"certification_date": "2021-09-17",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MD",
"license": "LC11919",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "BALTIMORE",
"affiliation": "N",
"address_1": "4 Pomona W Apt 10",
"city": "Pikesville",
"state": "MD",
"country_code": "US",
"postal_code": "212082950",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Pikesville, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 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.