NPIMap

Organization Active NPI

Gilead Christian Counseling LLC

  • Clinical Social Worker
  • Saint Leonard, MD
National Provider Identifier
1982089637
Registry record updated Jul 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
14689 Issued in MD
Legal business name
GILEAD CHRISTIAN COUNSELING LLC
Practice address
950 Calvert Beach Rd
Saint Leonard, MD 20685-2843
Phone
(443) 404-7366
NPI assigned
Jul 23, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2015

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

Authorized official

Name
Ms. Linda Anne Wilbanks, LCSW-CNPI 1568764736
Title
Owner
Phone
(443) 404-7366

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
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 14689 MD Primary

Addresses

Primary practice location

950 Calvert Beach Rd
Saint Leonard, MD 20685-2843

Mailing address

PO Box 282
Prince Frederick, MD 20678-0282
Phone (443) 404-7366

Other identifiers 1

IdentifierTypeStateIssuer
766938MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160926000227 MD Part B Supplier - Clinic/Group Practice 2365739927 Receives reassigned benefits from 1 practitioner
Practice locations: North Beach, MD

National Provider Directory

National Provider Directory

Locations

9120 Chesapeake Ave
Ste 201D
North Beach, MD 20714
Phone (443) 404-7366

65 Duke St
Ste 202
Prince Frederick, MD 20678
Phone (240) 682-2719

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1437609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437609600000",
    "number": "1982089637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 282",
            "city": "PRINCE FREDERICK",
            "state": "MD",
            "postal_code": "206780282",
            "telephone_number": "443-404-7366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 CALVERT BEACH RD",
            "city": "SAINT LEONARD",
            "state": "MD",
            "postal_code": "206852843",
            "telephone_number": "443-404-7366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GILEAD CHRISTIAN COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-23",
        "last_updated": "2015-07-23",
        "status": "A",
        "authorized_official_last_name": "WILBANKS",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "443-404-7366",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW-C"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "14689",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "766938",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Leonard, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.