# FULL POTENTIAL DMV

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1679341606
- **Authorized official:** MS. MICHELLE ANTOINETTA MCCRAY (CASE MANAGER)
- **Authorized official phone:** (202) 246-1062

## Contact information

- **Practice address:** 220 S FULTON AVE, BALTIMORE, MD 21223-3005
- **Practice address phone:** (202) 246-1062
- **Mailing address:** 220 S FULTON AVE, BALTIMORE, MD 21223-3005
- **Mailing address phone:** (202) 246-1062

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | — | — |
| 103K00000X | Behavior Analyst | — | — | — |
| 103TC0700X | Clinical Psychologist | — | — | — |
| 103TC1900X | Counseling Psychologist | — | — | — |
| 1041S0200X | School Social Worker | — | — | — |
| 106E00000X | Assistant Behavior Analyst | — | — | — |
| 106S00000X | Behavior Technician | — | — | — |
| 163WS0200X | School Registered Nurse | — | — | — |
| 171M00000X | Case Manager/Care Coordinator | — | — | Yes |
| 2084B0040X | Behavioral Neurology & Neuropsychiatry Physician | — | — | — |
| 2084P0800X | Psychiatry Physician | — | — | — |
| 2084P0804X | Child & Adolescent Psychiatry Physician | — | — | — |
| 231H00000X | Audiologist | — | — | — |
| 235Z00000X | Speech-Language Pathologist | — | — | — |
| 347C00000X | Private Vehicle | — | — | — |

## Other

- **Enumeration date:** 12/19/2023
- **Last updated:** 05/06/2024