| Advantage Psychiatric Services Llc | |
|
306 W Pulaski Hwy Elkton MD 21921-5217 | |
| (410) 686-3629 | |
| Not Available |
| Full Name | Advantage Psychiatric Services Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 306 W Pulaski Hwy, Elkton, Maryland |
| Authorized Official Name and Position | Cynthia Lynn Pixton (CEO/OWNER) |
| Authorized Official Contact | 4106863629 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Advantage Psychiatric Services Llc 5024 Campbell Blvd Ste A Nottingham MD 21236-5974 Ph: (410) 686-3629 | Advantage Psychiatric Services Llc 306 W Pulaski Hwy Elkton MD 21921-5217 Ph: (410) 686-3629 |
| NPI Number | 1548742554 |
|---|---|
| Provider Enumeration Date | 09/06/2018 |
| Last Update Date | 07/27/2021 |
| Certification Date | 07/27/2021 |
| Medicare PECOS PAC ID | 2860732039 |
|---|---|
| Medicare Enrollment ID | O20190326001310 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548742554 | NPI | - | NPPES |
| BH001126 | Other | MD | CLINIC LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | BH001126 (Maryland) | Primary |
| Provider Name | Abdulhafiz A Ahmed |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1508949496 PECOS PAC ID: 9537130729 Enrollment ID: I20160620001325 |
| Provider Name | Kara H Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558708206 PECOS PAC ID: 8729356613 Enrollment ID: I20170619000293 |
| Provider Name | Katelyn M Engbert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932636990 PECOS PAC ID: 9436418399 Enrollment ID: I20180131000370 |
| Provider Name | Frances Horzempa |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023665577 PECOS PAC ID: 4688905342 Enrollment ID: I20191010000347 |
| Provider Name | Lanona D Rezac |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194210898 PECOS PAC ID: 7911259312 Enrollment ID: I20200311000592 |
| Provider Name | Samantha Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659981264 PECOS PAC ID: 6305266321 Enrollment ID: I20201013002329 |
| Provider Name | David Mwangi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932707171 PECOS PAC ID: 3072929975 Enrollment ID: I20210301001044 |
| Provider Name | Taisha Renel Vinson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447763826 PECOS PAC ID: 6709284334 Enrollment ID: I20211012000552 |
| Provider Name | Katelynn Mae Liptak |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659868271 PECOS PAC ID: 1850789801 Enrollment ID: I20211025003282 |
| Provider Name | Adebola Abe-fapohunda |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083227177 PECOS PAC ID: 1759784812 Enrollment ID: I20211220001548 |
| Provider Name | Ruth Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356696231 PECOS PAC ID: 8325431299 Enrollment ID: I20220217001207 |
| Provider Name | Obinna Chukwuebuka Okonkwo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235893363 PECOS PAC ID: 4981098340 Enrollment ID: I20220301000056 |
| Provider Name | Stella Uwazunoye Aroh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861156077 PECOS PAC ID: 2365837887 Enrollment ID: I20220321001332 |
| Provider Name | Emmanuel A Gbala |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245862648 PECOS PAC ID: 5890181416 Enrollment ID: I20220407002738 |
| Provider Name | Justine Atugye Fokala-ndakwah |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790363828 PECOS PAC ID: 8325435407 Enrollment ID: I20220419001706 |
| Provider Name | Jartu Nylander |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376138131 PECOS PAC ID: 2567846595 Enrollment ID: I20220825000510 |
| Provider Name | Sherry Haywood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992452387 PECOS PAC ID: 3476920059 Enrollment ID: I20221110003199 |
| Provider Name | Marlene Reid |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538705645 PECOS PAC ID: 1658745344 Enrollment ID: I20230320002700 |
| Provider Name | Alison Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962077487 PECOS PAC ID: 5991159840 Enrollment ID: I20230926001692 |
| Provider Name | Gail Mumpower |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235786823 PECOS PAC ID: 9537513130 Enrollment ID: I20231002000779 |
| Provider Name | Dorothy Sexton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689232167 PECOS PAC ID: 5092160812 Enrollment ID: I20231016000587 |
| Provider Name | Amanda K Page |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053076117 PECOS PAC ID: 2163873068 Enrollment ID: I20240104002605 |
| Provider Name | Doris S Fair |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1659777225 PECOS PAC ID: 4880037225 Enrollment ID: I20240213001630 |
| Provider Name | Ethel Ann Bakke |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1225345937 PECOS PAC ID: 3577902147 Enrollment ID: I20240416000053 |
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