Organization Active NPI

Christian Counseling Center of Annapolis, Inc

  • Psychiatry Physician
  • Annapolis, MD
National Provider Identifier
1942587662
Registry record updated Nov 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
CHRISTIAN COUNSELING CENTER OF ANNAPOLIS, INC
Practice address
108 Old Solomons Island Rd
Annapolis, MD 21401-3845
Phone
(410) 266-8345
Fax
(410) 266-6278
NPI assigned
Nov 9, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2011

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

Authorized official

Name
Miss Sabrina Ann Mackall
Title
Administrative Assistant
Phone
(410) 266-8345

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

108 Old Solomons Island Rd
Annapolis, MD 21401-3845

Mailing address

108 Old Solomons Island Rd
Annapolis, MD 21401-3845
Phone (410) 266-8345

Other identifiers 2

IdentifierTypeStateIssuer
522901400MedicaidMD
S166OtherMDMEDICARE - UNSPECIFIED TYPE

National Provider Directory

National Provider Directory
Tax ID family
Christian Counseling Center of Annapolis Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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": "1320796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320796800000",
    "number": "1942587662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 OLD SOLOMONS ISLAND RD",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214013845",
            "telephone_number": "410-266-8345",
            "fax_number": "410-266-6278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 OLD SOLOMONS ISLAND RD",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214013845",
            "telephone_number": "410-266-8345",
            "fax_number": "410-266-6278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTIAN COUNSELING CENTER OF ANNAPOLIS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-09",
        "last_updated": "2011-11-09",
        "status": "A",
        "authorized_official_last_name": "MACKALL",
        "authorized_official_first_name": "SABRINA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "ADMINISTRATIVE ASSISTANT",
        "authorized_official_telephone_number": "410-266-8345",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "522901400",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE - UNSPECIFIED TYPE",
            "identifier": "S166",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Annapolis, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2011; 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.