1790052850 NPI number — COMPASS MUSIC THERAPY, LLC

Table of content: SAVIANNE VINTON MAHARAJ PSYD (NPI 1487972980)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790052850 NPI number — COMPASS MUSIC THERAPY, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COMPASS MUSIC THERAPY, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1790052850
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/17/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
643 RIDGEFIELD CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GLEN BURNIE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21061-4821
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
260-602-2568
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
643 RIDGEFIELD CT
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GLEN BURNIE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21061-4821
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-969-7399
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/17/2011

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
GARRISON
Authorized Official First Name:
JULIE
Authorized Official Middle Name:
EDGELL
Authorized Official Title or Position:
SENIOR MUSIC THERAPIST/OWNER
Authorized Official Telephone Number:
260-602-2568

Provider Taxonomy Codes

  • Taxonomy code: 225A00000X , with the licence number:  06805 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)