CERTIFIED COUNSELING SERVICES OF CENTREVILLE, LLC (NPI# 1871820258) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871820258 |
| Entity Type | Organization |
| Organization Name | CERTIFIED COUNSELING SERVICES OF CENTREVILLE, LLC |
| Practice Address |
204 Banjo Ln Ste A Centreville MD 21617-1054 |
| Mailing Address |
Po Box 23 Chestertown MD 21620-0023 |
| Practice Telephone | 4107584456 |
| Enumeration Date | 2009-11-05 |
| Last Update Date | 2009-11-05 |
| Authorized Official Name | JOSEPH KEITH JONES (DIRECTOR) |
| Authorized Official Telephone | 4107584456 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
LCA449 | MD | Ambulatory Health Care Facilities |
| Street Address |
204 BANJO LN STE A |
| City | CENTREVILLE |
| State | MD |
| Zip Code | 21617-1054 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518322445 | Marianna Edmonston | Occupational Therapy Assistant | 205 Armstrong St., Genesis Rehabilitation Services Corsica Hills, Centreville, MD 21617 | 2015-12-18 |
| 1881089084 | Michelle Katherine Priddy | Specialist/Technologist | 125 Ruthsburg Rd., Centreville, MD 21617 | 2015-04-03 |
| 1801220579 | Kimberly Patrice Wilson | Counselor | 205 North Liberty St, Centreville, MD 21617 | 2013-08-29 |
| 1588940787 | Angela Renee Sommer | Speech-Language Pathologist | 205 Armstrong Street, Genesis Rehabilitation Services Corsica Hills, Centreville, MD 21617 | 2011-11-01 |
| 1497067144 | Alison Lynn Mccuen | Speech-Language Pathologist | 175 Ashland Drive, Centreville, MD 21617 | 2010-07-10 |
| 1427269406 | Hospice of Queen Anne's Inc. | Hospice Care, Community Based | 255 Comet Drive, Centreville, MD 21617 | 2007-05-24 |
| 1093921470 | Lillian Sheehan | Social Worker | 152 Courseval Drive, Ste 142, Centreville, MD 21617 | 2007-05-15 |
| 1184723942 | Centreville Drugs Inc | Durable Medical Equipment & Medical Supplies | 102 Commerce Street, Centreville, MD 21617 | 2006-09-21 |
| 1114022670 | James J Lucas | Dentist | 134 Coursevall Drive, Centerville, MD 21617 | 2006-09-13 |
| 1730129370 | Joseph C Titus | Social Worker | 120 Banjo Lane, Centreville, MD 21617 | 2006-06-08 |
| Find all providers in zip 21617 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518472570 | Project Chesapeake, LLC | Clinic/Center | 202 Coursevall Dr Ste 104, Centreville, MD 21617-2805 | 2017-12-12 |
| 1295269785 | Corsica River Mental Health Services, Inc. | Clinic/Center | 120 Banjo Ln, Centreville, MD 21617-1002 | 2017-04-12 |
| 1891179099 | Corsica River Mental Health Services, Inc. | Clinic/Center | 120 Banjo Ln, Centreville, MD 21617-1002 | 2015-07-17 |
| 1851799936 | Queen Anne's County Health Department | Clinic/Center | 205 N Liberty St, Centreville, MD 21617-1022 | 2014-12-05 |
| 1174893556 | Queen Anne's County Health Department | Clinic/Center | 205 N Liberty St, Centreville, MD 21617-1022 | 2012-01-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043817075 | Maryland Community Health Initiatives, Inc. | Clinic/Center | 2648 Guilford Ave Apt 1fl, Baltimore, MD 21218-4611 | 2020-10-02 |
| 1851998892 | Maryland Community Health Initiatives, Inc. | Clinic/Center | 2648 Guilford Ave Apt 2fl, Baltimore, MD 21218-4611 | 2020-10-02 |
| 1801403324 | Maryland Community Health Initiatives, Inc. | Clinic/Center | 328 E 26th St, Baltimore, MD 21218-4702 | 2020-09-29 |
| 1275148975 | Hel Recovery Center | Clinic/Center | 1900 N Howard St Fl 2, Baltimore, MD 21218-5909 | 2020-09-10 |
| 1497365654 | Inspiring Change Mental Health Services, LLC. | Clinic/Center | 4654 York Rd Ste 1, Baltimore, MD 21212-4726 | 2020-08-03 |
| 1174132518 | Sabinas House LLC | Clinic/Center | 3103 Mareco Ave, Baltimore, MD 21213-1619 | 2020-07-30 |
| 1134738909 | Sabinas House LLC | Clinic/Center | 2224 Dukeland St, Baltimore, MD 21216-2812 | 2020-07-28 |
| 1881203792 | Sabinas House LLC | Clinic/Center | 3325 Shannon Dr, Baltimore, MD 21213-1823 | 2020-07-27 |
| 1356950265 | Sabinas House LLC | Clinic/Center | 616 Wildwood Pkwy, Baltimore, MD 21229-1810 | 2020-07-27 |
| 1598374407 | Sabinas House LLC | Clinic/Center | 605 Springfield Ave, Baltimore, MD 21212-4832 | 2020-07-27 |
| Find all providers with the same taxonomy | ||||
| City | CENTREVILLE |
| Zip Code | 21617 |
Please comment or provide details below to improve the information on CERTIFIED COUNSELING SERVICES OF CENTREVILLE, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.