NPIMap

Organization Active NPI

Connected Self, LLC

  • Marriage & Family Therapist
  • Bowie, MD
National Provider Identifier
1932270568
Registry record updated Mar 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LCM130 Issued in MD
Legal business name
CONNECTED SELF, LLC
Practice address
3012 Mitchellville Rd
Suite 103
Bowie, MD 20716-3986
Phone
(301) 218-0836
Fax
(301) 218-0836
NPI assigned
Nov 13, 2006
Last updated
Mar 10, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2014

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

Authorized official

Name
Ms. Merlina Alyce Perkowski, LCMFTNPI 1225109861
Title
Owner, Sole Therapist
Phone
(301) 218-0836

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X LCM130 MD Primary

Addresses

Primary practice location

3012 Mitchellville Rd
Suite 103
Bowie, MD 20716-3986

Mailing address

3012 Mitchellville Rd
Suite 103
Bowie, MD 20716-3986
Phone (301) 218-0836

Other identifiers 2

IdentifierTypeStateIssuer
361133OtherMDMHN
511509400MedicaidMD

National Provider Directory

National Provider Directory

Locations

3012 Mitchellville Rd
Ste 103
Bowie, MD 20716
Phone (301) 218-0836

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394409600000",
    "number": "1932270568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3012 MITCHELLVILLE RD",
            "address_2": "SUITE 103",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207163986",
            "telephone_number": "301-218-0836",
            "fax_number": "301-218-0836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3012 MITCHELLVILLE RD",
            "address_2": "SUITE 103",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207163986",
            "telephone_number": "301-218-0836",
            "fax_number": "301-218-0836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONNECTED SELF, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-13",
        "last_updated": "2014-03-10",
        "status": "A",
        "authorized_official_last_name": "PERKOWSKI",
        "authorized_official_first_name": "MERLINA",
        "authorized_official_middle_name": "ALYCE",
        "authorized_official_title_or_position": "OWNER, SOLE THERAPIST",
        "authorized_official_telephone_number": "301-218-0836",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCMFT"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MD",
            "license": "LCM130",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHN",
            "identifier": "361133",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "511509400",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowie, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 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.

Verify at the official NPI Registry.