VITAL SOURCES, LLC (NPI# 1770605321) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770605321 |
| Entity Type | Organization |
| Organization Name | VITAL SOURCES, LLC |
| Practice Address |
116 Record St Frederick MD 21701-5418 |
| Practice Telephone | 3016208700 |
| Practice Fax Number | 3016208710 |
| Mailing Telephone | 3016208700 |
| Mailing Fax Number | 3016208710 |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2016-07-05 |
| Authorized Official Name | JAMES E. ROEMBKE JR. (MEMBER) |
| Authorized Official Telephone | 3016208700 |
| Authorized Official Credential | PSY.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YP2500X |
Counselor Specialization: Professional |
Behavioral Health & Social Service Providers | ||
| N | 103T00000X | Psychologist | Behavioral Health & Social Service Providers | ||
| N | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
Behavioral Health & Social Service Providers | ||
| N | 103TF0000X |
Psychologist Specialization: Family |
Behavioral Health & Social Service Providers | ||
| N | 103TF0200X |
Psychologist Specialization: Forensic |
Behavioral Health & Social Service Providers | ||
| N | 103TP0814X |
Psychologist Specialization: Psychoanalysis |
Behavioral Health & Social Service Providers | ||
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
Behavioral Health & Social Service Providers |
| Street Address |
116 RECORD ST |
| City | FREDERICK |
| State | MD |
| Zip Code | 21701-5418 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285756767 | James E. Roembke Jr. | Psychologist | 116 Record St, Frederick, MD 21701-5418 | 2007-04-04 |
| 1386136356 | Joshua A Kalman | Psychologist | 116 Record St, Frederick, MD 21701-5418 | 2018-06-05 |
| 1982195848 | Kathleen Musslewhite | Psychologist | 116 Record St, Frederick, MD 21701-5418 | 2018-05-25 |
| 1760835318 | Jill Marie Verschaetse | Psychologist | 116 Record St, Frederick, MD 21701-5418 | 2016-07-19 |
| 1366892234 | David John Cruzan | Counselor | 116 Record St, Frederick, MD 21701-5418 | 2016-06-21 |
| 1124493754 | Anita Raina Raj Hadden | Marriage & Family Therapist | 116 Record St, Frederick, MD 21701-5418 | 2015-12-08 |
| 1548643505 | Erik Hadden | Counselor | 116 Record St, Frederick, MD 21701-5418 | 2015-07-08 |
| 1104220664 | Pamela R Shepp | Counselor | 116 Record St, Frederick, MD 21701-5418 | 2014-10-13 |
| 1447573555 | Charlanne Michelle Wolff | Counselor | 116 Record St, Frederick, MD 21701-5418 | 2010-03-03 |
| 1932221421 | Margery F. Brubaker | Counselor | 116 Record St, Frederick, MD 21701-5418 | 2007-04-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225670045 | Alana Earp | Social Worker | 810 Toll House Avenue, Frederick, MD 21701 | 2019-10-14 |
| 1851866065 | Main Place Treatment Centers LLC. | Clinic/Center | 127 S. Smallwood Street, Frederick, MD 21701 | 2018-10-04 |
| 1649775933 | Old Fashion Medicine, Inc | Internal Medicine | 95 Gatepost Lane, Apartment 1b, Frederick, MD 21701 | 2018-03-28 |
| 1063917938 | Kristin Deely | Nurse Practitioner | 400 West 7th Street, Cardiac Cath Lab 2nd Floor, Frederick, MD 21701 | 2018-03-24 |
| 1689180119 | Harwood Behavioral Health Partners, LLC | Community/Behavioral Health | 300 B Scholls Lane, Frederick, MD 21701 | 2017-12-20 |
| 1326590068 | Natalie Reid | Nurse Practitioner | 9093 Ridgefield Dr Ste 104, Frederick, MD 21701 | 2016-10-28 |
| 1649727967 | Scl Corpration | In Home Supportive Care | 550 Highland Street, Suite 110, Frederick, MD 21701 | 2016-09-02 |
| 1891159661 | Wellave, LLC | Clinic/Center | 411 Aviation Way Ste 245, Frederick, MD 21701 | 2016-04-07 |
| 1144694969 | Leslee Bry | Counselor | 120 W Church St Ste 3b, Frederick, MD 21701 | 2015-11-17 |
| 1851797732 | Frederick Dental | Dentist | 401 W 7th Street, Frederick Dental, Frederick, MD 21701 | 2014-11-05 |
| Find all providers in zip 21701 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053756908 | Shouh-rong Vivian Tsai | Psychologist | 5301 Buckeystown Pike Ste 440, Frederick, MD 21704-8319 | 2013-05-06 |
| 1386876811 | Monica Kristine Pentony | Psychologist | 10142 Hansonville Rd, Frederick, MD 21702-1919 | 2009-08-18 |
| 1205002029 | Helene G Brenner | Psychologist | 97 S Mccain Dr, Ste. B, Frederick, MD 21703-6055 | 2008-05-01 |
| 1194906180 | Elise G. Abromson | Psychologist | 620 W Patrick St, Frederick, MD 21701-4028 | 2007-11-18 |
| 1316146566 | Maryland Counseling Centers, Inc. | Psychologist | 5300 Westview Dr., Bldg. 100, Suite 104, Frederick, MD 21703-8327 | 2007-07-17 |
| 1710193156 | Margaret Rose Bowman | Psychologist | 1497 Dogwood Dr, Frederick, MD 21701-4487 | 2007-05-15 |
| 1316163090 | John Patrick Farrell | Psychologist | 97b S Mccain Dr, Frederick, MD 21703-6055 | 2007-04-18 |
| 1396877189 | Health and Happiness LLC | Psychologist | 93 S Mccain Drive, Frederick, MD 21703 | 2007-03-09 |
| 1649363037 | Brenda Ann Vidal | Psychologist | 6441 Jefferson Pike, Frederick, MD 21703-7039 | 2006-09-30 |
| 1487766788 | Jennifer L Carter | Psychologist | 97 S Mccain Dr # B, Frederick, MD 21703-6055 | 2006-08-31 |
| Find all providers in FREDERICK | ||||
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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.