MATCLINIC PHYSICIANS PRACTICE GROUP LLC (NPI# 1194217091) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194217091 |
| Entity Type | Organization |
| Organization Name | MATCLINIC PHYSICIANS PRACTICE GROUP LLC |
| Practice Address |
601 7th St Ste 304 Laurel MD 20707-4011 |
| Mailing Address |
503 Albemarle St Baltimore MD 21202-4304 |
| Practice Telephone | 4102200280 |
| Practice Fax Number | 4108620150 |
| Mailing Telephone | 4102200780 |
| Mailing Fax Number | 4108620150 |
| Enumeration Date | 2018-06-06 |
| Last Update Date | 2020-08-07 |
| Authorized Official Name | DAN RECK (MANAGER) |
| Authorized Official Telephone | 4102200780 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers | ||
| N | 101YP2500X |
Counselor Specialization: Professional |
Behavioral Health & Social Service Providers | ||
| N | 207RA0401X |
Internal Medicine Specialization: Addiction Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 2084A0401X |
Psychiatry & Neurology Specialization: Addiction Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians | ||
| N | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | 818073300 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548825813 | Matclinic Physicians Practice Group LLC | Counselor | 40 York Rd Ste 201, Towson, MD 21204-5243 | 2019-05-02 |
| 1356801534 | Matclinic Physicians Practice Group LLC | Internal Medicine | 107 Ridgely Ave Ste 12, Annapolis, MD 21401-1417 | 2019-03-22 |
| 1699385336 | Matclinic Physicians Practice Group LLC | Clinic/Center | 40 York Rd Ste 201, Towson, MD 21204-5243 | 2020-08-07 |
| 1417567157 | Matclinic Physicians Practice Group LLC | Clinic/Center | 601 7th St Ste 304, Laurel, MD 20707-4011 | 2020-08-07 |
| 1336759075 | Matclinic Physicians Practice Group LLC | Clinic/Center | 40 S Dundalk Ave Ste 400, Dundalk, MD 21222-4273 | 2020-08-07 |
| 1316557051 | Matclinic Physicians Practice Group LLC | Clinic/Center | 107 Ridgely Ave Ste 12, Annapolis, MD 21401-1417 | 2020-08-07 |
| 1841840808 | Matclinic Physicians Practice Group LLC | Community/Behavioral Health | 107 Ridgely Ave Ste 12, Annapolis, MD 21401-1417 | 2019-09-12 |
| 1669022620 | Matclinic Physicians Practice Group LLC | Community/Behavioral Health | 40 York Rd Ste 201, Towson, MD 21204-5243 | 2019-09-12 |
| 1750930863 | Matclinic Physicians Practice Group LLC | Clinic/Center | 601 7th St Ste 304, Laurel, MD 20707-4011 | 2019-09-11 |
| 1821647934 | Matclinic Physicians Practice Group LLC | Clinic/Center | 107 Ridgely Ave Ste 12, Annapolis, MD 21401-1417 | 2019-09-11 |
| Street Address |
601 7TH ST STE 304 |
| City | LAUREL |
| State | MD |
| Zip Code | 20707-4011 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417567157 | Matclinic Physicians Practice Group LLC | Clinic/Center | 601 7th St Ste 304, Laurel, MD 20707-4011 | 2020-08-07 |
| 1750930863 | Matclinic Physicians Practice Group LLC | Clinic/Center | 601 7th St Ste 304, Laurel, MD 20707-4011 | 2019-09-11 |
| 1447809462 | Matclinic Physicians Practice Group LLC | Community/Behavioral Health | 601 7th St Ste 304, Laurel, MD 20707-4011 | 2019-09-11 |
| 1265084727 | Matclinic Physicians Practice Group LLC | Counselor | 601 7th St Ste 304, Laurel, MD 20707-4011 | 2019-07-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376157156 | Mini'imah Wilson | Social Worker | 15041 Cherrywood Dr, Laurel, MD 20707 | 2020-08-31 |
| 1548893985 | Ernest Freeman | Clinic/Center | 367 Main St., Laurel, Laurel, MD 20707 | 2020-02-13 |
| 1538701859 | Family Health and Wellness Clinic LLC | Clinic/Center | 324 Main St. #523, Laurel, MD 20707 | 2019-10-09 |
| 1467018226 | Leena Daniel | Nurse Practitioner | 13 C Street, Suite D, Laurel, MD 20707 | 2019-05-16 |
| 1538723143 | Florence Okojie | Nurse Practitioner | 13 C St Ste G, Laurel, MD 20707 | 2019-04-29 |
| 1487148631 | Munsha Sidhu Chadha | Dentist | 595 Main St Ste 237, Laurel, MD 20707 | 2018-06-20 |
| 1568953370 | Carleen Graham Schwimmer | Clinical Neuropsychologist | Veterans Affairs War Related Illness & Injury (wriisc), 50 Irving Street Nw, Washington, MD 20707 | 2018-05-29 |
| 1043709637 | Bk Behavioral Health Center | Behavior Technician | 14300 Cherry Lane Ct Ste 202-203, Laurel, MD 20707 | 2018-05-09 |
| 1053800839 | Bk Behaviorial Health Center | Substance Abuse Rehabilitation Facility | 14300 Cherry Lane Court, Suite 202-203, Laurel, MD 20707 | 2018-05-07 |
| 1316435795 | Laurel Pharmacy II LLC | Pharmacy | 14402 Baltimore Ave, Laurel, MD 20707 | 2018-05-01 |
| Find all providers in zip 20707 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275898751 | Odelia Muir | Counselor | 13184 Larchdale Rd, Apt #6, Laurel, MD 20708-1707 | 2012-07-10 |
| 1346574282 | Reflections Clinical Counseling, LLC | Counselor | 13 C St Ste C, Laurel, MD 20707-4152 | 2009-09-24 |
| 1447482237 | Jerry V Ridge | Counselor | 7 Line Rd, Laurel, MS 39443-2663 | 2009-08-13 |
| 1326174699 | Kathy Guthrie | Counselor | 111 Mechanic St, Laurel, DE 19956-1004 | 2007-02-23 |
| 1912049719 | Rosalind Serena Rose | Counselor | 1615 Pheasant Brook Circle, Suite 2, Laurel, MT 59044-9314 | 2007-02-12 |
| 1902957319 | Counseling Services, Inc. | Counselor | 150 Washington Blvd S Fl 2, Laurel, MD 20707-4328 | 2007-01-13 |
| 1295225761 | Bk Behavioral Health Center | Counselor | 14300 Cherry Lane Ct Ste 202-203, Laurel, MD 20707-4958 | 2018-05-10 |
| 1437602588 | American Center for Intellectual and Diverse Disorders for Counseling | Counselor | 300 Thomas Dr, Suite A, Laurel, MD 20707-4700 | 2016-07-25 |
| 1073932380 | Julie Mcmillin | Counselor | 319 1st Ave, Laurel, MT 59044-3031 | 2014-04-15 |
| 1356602528 | Sharon M Bell | Counselor | 413 Main Street, Laurel, MD 20707 | 2012-06-05 |
| Find all providers in LAUREL | ||||
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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.