NPIMap

Organization Active NPI

Imara Counseling Services

  • Mental Health Counselor
  • Laurel, MD
National Provider Identifier
1932658671
Registry record updated Oct 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LC6147 Issued in MD
Legal business name
IMARA COUNSELING SERVICES
Practice address
8101 Sandy Spring Rd
250
Laurel, MD 20707-3596
Phone
(301) 821-0049
NPI assigned
Sep 22, 2016
Last updated
Oct 15, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2016

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

Authorized official

Name
David DefoeNPI 1124452123
Title
Owner
Phone
(301) 821-0049

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X LC6147 MD Primary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X LC6147 MD

Addresses

Primary practice location

8101 Sandy Spring Rd
250
Laurel, MD 20707-3596

Mailing address

8101 Sandy Spring Rd
250
Laurel, MD 20707-3596
Phone (301) 821-0049

Other identifiers 1

IdentifierTypeStateIssuer
718002100MedicaidMD

National Provider Directory

National Provider Directory

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": "1474502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476489600000",
    "number": "1932658671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8101 SANDY SPRING RD",
            "address_2": "250",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207073596",
            "telephone_number": "301-821-0049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8101 SANDY SPRING RD",
            "address_2": "250",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207073596",
            "telephone_number": "301-821-0049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMARA COUNSELING SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-22",
        "last_updated": "2016-10-15",
        "status": "A",
        "authorized_official_last_name": "DEFOE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "301-821-0049"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "LC6147",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LC6147",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "718002100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurel, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2016; 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.