GAIA HOLISTIC COUNSELING SERVICES LLC , NPI 1295909307 — CUMBERLAND (MD)

NPI 1295909307

11+ Years Experience Organization

GAIA HOLISTIC COUNSELING SERVICES LLC

04/18/2008
PROVIDER ENUMERATION DATE
04/18/2008
LAST UPDATE DATE
1295909307
NPI NUMBER

About GAIA HOLISTIC COUNSELING SERVICES LLC

GAIA HOLISTIC COUNSELING SERVICES LLC is a provider established in CUMBERLAND, MD. The NPI number of GAIA HOLISTIC COUNSELING SERVICES LLC is 1295909307 and was assigned on 04/18/2008. The practitioners primary taxonomy code is: 104100000X with license number: 13631 MD .

Mailing address

  • City: CUMBERLAND
  • State: MD
  • Postal code: 21502
  • Phone: 3017770620
  • Fax: 3017772906
  • Address: 134 BALTIMORE ST

Primary Practice Address

  • Region : CUMBERLAND, MD
  • NPI : 1295909307
  • Phone : 3017770620
  • Fax : 3017772906
  • Postalcode : 21502
  • Address : 134 BALTIMORE ST

Provider taxonomy - Social Worker

  • Taxonomy code: 104100000X
  • License number: 13631
  • License state: MD

The taxonomy is not the primary taxonomy.

Taxonomy group: 193200000X MULTI-SPECIALTY GROUP.

Taxonomy description: A social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public.

Healthcare provider taxonomy #2 - Counselor

  • Taxonomy code: 101Y00000X
  • License number: LC1720
  • License state: MD

The taxonomy is the primary taxonomy (there can be only one per NPI record).

Taxonomy description: A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master"s degree and clinical experience and supervision for licensure or certification.

Contacts:

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  • GAIA HOLISTIC COUNSELING SERVICES LLC
  • Address : 134 BALTIMORE ST
  • Region : CUMBERLAND, MD
  • NPI : 1295909307
  • Phone : 3017770620
  • Fax : 3017772906
  • Postalcode : 21502

Authorized official :

{:AUTHORIZED_OFFICIAL_FIRST_NAME:} {:AUTHORIZED_OFFICIAL_MIDDLE_NAME:} {:AUTHORIZED_OFFICIAL_LAST_NAME:}
  • Phone : 3017770620
  • Title or position : MEDICAL DIRECTOR
  • Credentials : MD

Reference NPI Information. Full replica of the CMS (NPPES) NPI record

Field Name Value
Provider First Line Business Practice Location Address134 BALTIMORE ST
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City NameCUMBERLAND
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameMD
The State or Province name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code21502
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Telephone Number3017770620
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number3017772906
The fax number associated with the location address of the provider being identified.
NPI1295909307
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Healthcare Provider Taxonomy 1104100000X
A social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public.
Provider Enumeration Date04/18/2008
The date the provider was assigned a unique identifier (assigned an NPI).
Last Updated04/18/2008
The date that a record was last updated or changed.
Entity TypeOrganization
Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Is Organization SubpartN
The "Is the organization a subpart?" question must be answered. If the organization is a subpart, the Parent Organization Legal Business Name (LBN) and Parent Organization Taxpayer Identification Number (TIN) fields must be completed. The Parent Organization LBN and TIN fields can only be completed if the answer to the subpart question is Yes. Many organization health care providers who apply for NPIs are not legal entities themselves but are parts of other organization health care providers that are legal entities (the "parents"). Here are three examples of organization health care providers that may be considered subparts and may apply for NPIs if so directed by their "parents": (1) The psychiatric unit in a hospital is not a legal entity but is part of the hospital (the "parent"), which is a legal entity. The legal entity must obtain an NPI. The psychiatric unit is an example of a subpart that could have its own NPI if the hospital determines that it should. (2) A group practice that is not a sole proprietorship has a main location and could have other offices in different locations, but each office is not a separate legal entity; instead, each office is part of the corporation (the "parent") which is a legal entity. The offices are examples of subparts that could have their own NPIs if the main location determines that they should. (3) A pharmacy fills prescriptions for patients whose physicians have prescribed medications for them and may also rent or sell durable medical equipment to patients whose physicians have ordered such equipment for them. Neither the pharmacy line of business nor the DME line of business represent legal entities; instead, both lines of business are part of an organization (the "parent") that is a legal entity. Each line of business represents a different Healthcare Provider Taxonomy or area of specialization that often submits its own electronic claims to health plans. The "parent"-we don"t know who the parent is in this example-must ensure that each subpart that submits its own claims to health plans has its own NPI.
Provider Organization Name (Legal Business Name)GAIA HOLISTIC COUNSELING SERVICES LLC
Provide organization name (legal business name used to file tax returns with the IRS). The Organization Name field allows the following special characters: ampersand, apostrophe, "at" sign, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters.
Provider First Line Business Mailing Address134 BALTIMORE ST
The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Business Mailing Address City NameCUMBERLAND
The City name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address City name".
Provider Business Mailing Address State NameMD
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code21502
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Provider Business Mailing Address Telephone Number3017770620
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
Provider Business Mailing Address Fax Number3017772906
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as "Provider location address fax number".
Authorized Official Last NameLYNN
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First NameROBERT
The first name of the authorized official
Authorized Official Middle NameLYNN
The middle name of the authorized official
Authorized Official Title or PositionMEDICAL DIRECTOR
The title or position of the authorized official
Authorized Official Name Prefix TextDR.
Authorized Official Name Prefix Text
Authorized Official Credential TextMD
Authorized Official Credential Text
Authorized Official Telephone Number3017770620
The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code #1104100000X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 1Social Worker
A social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public.
Provider License Number 113631
Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section.
Provider License Number State Code 1MD
Healthcare Provider Primary Taxonomy Switch 1N
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Healthcare Provider Taxonomy Code 2101Y00000X
Healthcare Provider Taxonomy 2Counselor
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master"s degree and clinical experience and supervision for licensure or certification.
Provider License Number 2LC1720
Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section.
Provider License Number State Code 2MD
Healthcare Provider Primary Taxonomy Switch 2Y
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
X

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