PORT RECOVERY IOP INC. NPI 1578026464

NPI Information

  • NPI: 1578026464
  • Provider Name: PORT RECOVERY IOP INC.
  • Classification: Counselor - 101YM0800X
  • Specialization: Mental Health
  • Entity Type: Organization
  • Address: 8615 RIDGELYS CHOICE DR STE 205
    NOTTINGHAM, MD
    ZIP 21236
  • Phone: (443) 869-4909

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NPI Details

PORT RECOVERY IOP INC. is a mental health counselor in Nottingham, MD. PORT RECOVERY IOP INC. NPI is 1578026464. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

8615 RIDGELYS CHOICE DR STE 205
NOTTINGHAM, MD
ZIP 21236-028
Phone: (443) 869-4909
Fax: (443) 869-4928

The provider's authorized official is Joanne Granruth .
The authorized official title is Owner and has the following contact phone number (410) 534-8735.

The enumeration date for this NPI number is 4/9/2019 and was last updated on 4/9/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YP2500XCounselorProfessionalNo
21041C0700XSocial WorkerClinicalNo
32084P0800XPsychiatry & NeurologyPsychiatryNo
4363LP0808XNurse PractitionerPsychiatric/Mental HealthNo
5101YM0800XCounselorMental HealthYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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