STACEY MICHELLE LANDRIE (NPI# 1972081842) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972081842 |
| Entity Type | Individual |
| Full Name | STACEY MICHELLE LANDRIE |
| Practice Address |
828 Airpax Rd Ste 300 Cambridge MD 21613-6401 |
| Practice Telephone | 4109011333 |
| Mailing Telephone | 4109011333 |
| Enumeration Date | 2018-08-02 |
| Last Update Date | 2018-08-02 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers | ||
| Y | 324500000X | Substance Abuse Rehabilitation Facility | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | 1770906901 | 05 |
| Street Address |
828 AIRPAX RD STE 300 |
| City | CAMBRIDGE |
| State | MD |
| Zip Code | 21613-6401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225427289 | A Better Alternative Nursing Avency, Inc | Nursing Care | 204 Cedar Street, Canbridge, MD 21613 | 2015-01-14 |
| 1497048524 | Christina Marie Drostin | Family Medicine | 503 A Muir Street, Cambridge, MD 21613 | 2011-05-23 |
| 1841589058 | Wal-mart Stores East Lp | Technician/Technologist | 2775 Dorchester Square, Cambridge, MD 21613 | 2011-03-29 |
| 1053624452 | Gina Exantus-bernard | Pediatrics | 400 Byrn St Ste A, Cambridge, MD 21613 | 2010-07-14 |
| 1235362872 | St of Md/dhmh Dorchester Co Health Dept | Public Health or Welfare | 2475 Cambridge Bypass, Cambridge, MD 21613 | 2009-08-31 |
| 1801916622 | Alisha Foxwell Saulsbury | Social Worker | 208 Cedar St, Cambridge, MD 21613 | 2007-03-29 |
| 1497890669 | Charles Edmund Connelly Jr. | Dentist | 406 Lecompte Street, Cambridge, MD 21613 | 2007-02-21 |
| 1114088192 | Delmarva Community Services Inc | Nursing Care | 6210 Shiloh Church Hurlock Rd, Hurlock, MD 21613 | 2006-12-13 |
| 1184782658 | Lesa M Lee | Social Worker | 403 Race Street, Cambridge, MD 21613 | 2006-12-05 |
| 1750455747 | Jenny Lynne Jarrell | Social Worker | 208 Cedar Street, Cambridge, MD 21613 | 2006-11-20 |
| Find all providers in zip 21613 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508367558 | Future Focus LLC | Substance Abuse Rehabilitation Facility | 708 Church St, Cambridge, MD 21613-1783 | 2018-02-26 |
| 1548417918 | Amp-cep Group Homes, Inc. | Substance Abuse Rehabilitation Facility | 828 Airpax Rd, 200, Cambridge, MD 21613-6405 | 2008-08-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477151066 | Evolve Residential, LLC | Substance Abuse Rehabilitation Facility | 486 Lincoln Dr, Glen Burnie, MD 21060-8706 | 2020-10-15 |
| 1841898434 | Evolve Residential, LLC | Substance Abuse Rehabilitation Facility | 394 Washington Ave, Glen Burnie, MD 21060-8712 | 2020-10-15 |
| 1942808050 | Powell Recovery Center, Inc. | Substance Abuse Rehabilitation Facility | 10 S Broadway, Baltimore, MD 21231-1775 | 2020-10-12 |
| 1396343414 | Powell Recovery Center, Inc. | Substance Abuse Rehabilitation Facility | 15 S Broadway, Baltimore, MD 21231-1714 | 2020-10-12 |
| 1801494984 | Evolve Residential, LLC | Substance Abuse Rehabilitation Facility | 8315 Veterans Hwy, Millersville, MD 21108-1421 | 2020-10-12 |
| 1124626296 | Evolve Residential, LLC | Substance Abuse Rehabilitation Facility | 390 Washington Ave, Glen Burnie, MD 21060-8712 | 2020-10-12 |
| 1457968984 | Powell Recovery Center | Substance Abuse Rehabilitation Facility | 22 S Broadway, Baltimore, MD 21231-1711 | 2020-09-29 |
| 1356956676 | The Elysian Fields Optimum Wellness and Mental Health Group, LLC | Substance Abuse Rehabilitation Facility | 2901 Erdman Ave, Baltimore, MD 21213-1139 | 2020-09-14 |
| 1134731284 | Serenity Keepers of Maryland LLC | Substance Abuse Rehabilitation Facility | 3645 Cottage Ave, Baltimore, MD 21215-7725 | 2020-08-20 |
| 1255949392 | Champ House Recovery Inc. | Substance Abuse Rehabilitation Facility | 8655 Normal School Rd, Bowie, MD 20715-3326 | 2020-07-15 |
| Find all providers with the same taxonomy | ||||
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| 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.