MRS. BRENDA DORSCH IBUTU (NPI# 1356644116) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356644116 |
| Entity Type | Individual |
| Full Name | MRS. BRENDA DORSCH IBUTU |
| Credential | LCPC |
| Practice Address |
3902 Annapolis Rd Lansdowne MD 21227-2249 |
| Practice Telephone | 4107892647 |
| Practice Fax Number | 4107898364 |
| Mailing Telephone | 4107896247 |
| Mailing Fax Number | 4107898364 |
| Enumeration Date | 2010-12-15 |
| Last Update Date | 2010-12-15 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101Y00000X | Counselor | LC3573 | MD | Behavioral Health & Social Service Providers |
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
LC3573 | MD | Behavioral Health & Social Service Providers |
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
LC3573 | MD | Behavioral Health & Social Service Providers |
| N | 101YP1600X |
Counselor Specialization: Pastoral |
LC3573 | MD | Behavioral Health & Social Service Providers |
| N | 101YP2500X |
Counselor Specialization: Professional |
LC3573 | MD | Behavioral Health & Social Service Providers |
| Street Address |
3902 ANNAPOLIS RD |
| City | LANSDOWNE |
| State | MD |
| Zip Code | 21227-2249 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215447776 | Kristine Newsome | Registered Nurse | 3902 Annapolis Rd, Lansdowne, MD 21227-2249 | 2017-10-10 |
| 1114385515 | Georgina Sackey | Registered Nurse | 3902 Annapolis Rd, Lansdowne, MD 21227-2249 | 2016-02-01 |
| 1194018630 | John Allen Jones | Counselor | 3902 Annapolis Rd, Lansdowne, MD 21227-2249 | 2011-05-17 |
| 1841346798 | Baltimore County Department of Health | Public Health or Welfare | 3902 Annapolis Rd, Lansdowne, MD 21227-2210 | 2007-01-25 |
| 1215099395 | Ma. Anna Teresa Mapa | Counselor | 3902 Annapolis Rd, Lansdowne, MD 21227-2210 | 2006-12-14 |
| 1538227202 | Friends Research Institute, Inc. | Counselor | 3902 Annapolis Rd, Lansdowne, MD 21227-2210 | 2006-12-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528622024 | Kim Conaway | Counselor | Regenerations Counseling Services, 1421 S. Canton Street, Baltimore, MD 21227 | 2019-04-30 |
| 1861974891 | Joan Lynn Indilisano | Occupational Therapist | 3320 Benson Avenue, Baltimore, MD 21227 | 2018-09-06 |
| 1821593161 | Institute for Dermatopathology, Inc. | Clinical Medical Laboratory | 1901 Sulphur Spring Rd Ste A, Baltimore, MD 21227 | 2018-03-28 |
| 1447779699 | Aja Williams | Registered Nurse | 3902 Annapolis Rd., Halethorpe, MD 21227 | 2017-09-19 |
| 1588190748 | Mentor-maryland | Community/Behavioral Health | 1540 Caton Center Drive, Halethorpe, MD 21227 | 2017-05-10 |
| 1083084180 | Institute for Family Centered Services | Community/Behavioral Health | 1540 Caton Centered Drive, Suite F, Baltimore, MD 21227 | 2015-10-01 |
| 1174913677 | Wye Oak Clinic, Inc. | Marriage & Family Therapist | 1937 Lansdowne Rd, Halethorpe, MD 21227 | 2015-02-04 |
| 1588938237 | Ahmein Watson | Social Worker | 1504 Joh Ave Ste 120, Baltimore, MD 21227 | 2012-02-28 |
| 1336442656 | Norah Orise Osian | Pharmacist | Rite Aid Pharmacy, 1400 Sulphur Spring Rd, Baltimore, MD 21227 | 2010-12-08 |
| 1366759623 | Een J Lee | Pharmacist | 1400 Sulphurspring Rd, Baltimore, MD 21227 | 2010-09-08 |
| Find all providers in zip 21227 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396309100 | Jean Luc Bertier | Counselor | 220 Crawford Ave, Lansdowne, PA 19050-1404 | 2019-04-26 |
| 1932560018 | Charles Williams | Counselor | 115 W Greenwood Ave, Lansdowne, PA 19050-1551 | 2016-03-16 |
| 1295129708 | Campbell Anderson | Counselor | 58 N Lansdowne Ave, S 205, Lansdowne, PA 19050-1953 | 2015-03-23 |
| 1861896276 | Myriam Rosefort | Counselor | 315 Wayne Ave, Lansdowne, PA 19050-1036 | 2014-10-14 |
| 1407267917 | Holly Suzanne Ameen | Counselor | 19420 Golf Vista Plz Ste 250, Lansdowne, VA 20176-8267 | 2014-05-19 |
| 1528397684 | Emris Bernadette Grant | Counselor | 173 Houston Rd, Lansdowne, PA 19050-1709 | 2009-12-18 |
| 1063640381 | Kia Felicia Everett | Counselor | 232 Le Carra Dr, Lansdowne, PA 19050-1718 | 2009-06-25 |
| 1750542460 | Mark Alan Davis Sr. | Counselor | 147 Bryn Mawr Ave, Lansdowne, PA 19050-1806 | 2008-06-24 |
| 1689884926 | Mark Dean | Counselor | 42 Windermere Ave, Lansdowne, PA 19050-1812 | 2007-05-23 |
| 1790826964 | Maria Euterpe Gregory | Counselor | 19 W Stewart Ave, Lansdowne, PA 19050-1905 | 2007-02-09 |
| Find all providers in LANSDOWNE | ||||
Please comment or provide details below to improve the information on MRS. BRENDA DORSCH IBUTU.
| 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.