| Ags Programs Llc | |
|
1807 E. Preston Street Wolfe Street Suite Baltimore MD 21213 | |
| (410) 276-2123 | |
| (410) 276-4070 |
| Full Name | Ags Programs Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1807 E. Preston Street, Baltimore, Maryland |
| Authorized Official Name and Position | Raschid S. Smith (PRESIDENT/CEO) |
| Authorized Official Contact | 4102762123 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ags Programs Llc 1807 E Preston St Baltimore MD 21213-3131 Ph: (410) 276-2123 | Ags Programs Llc 1807 E. Preston Street Wolfe Street Suite Baltimore MD 21213 Ph: (410) 276-2123 |
| NPI Number | 1700398914 |
|---|---|
| Provider Enumeration Date | 10/27/2017 |
| Last Update Date | 05/03/2021 |
| Certification Date | 05/03/2021 |
| Medicare PECOS PAC ID | 7416364484 |
|---|---|
| Medicare Enrollment ID | O20210319000014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700398914 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Marta Echevarria Wild |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1659463305 PECOS PAC ID: 6507051364 Enrollment ID: I20101108000101 |
| Provider Name | Tonya Marie Conyers |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538453212 PECOS PAC ID: 2264668854 Enrollment ID: I20131205000004 |
| Provider Name | Glenda Laprade |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184239782 PECOS PAC ID: 2769899194 Enrollment ID: I20210331000048 |
| Provider Name | Raschid Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578033734 PECOS PAC ID: 8325455397 Enrollment ID: I20210331000142 |
| Provider Name | Jamika A White |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639788904 PECOS PAC ID: 6800203100 Enrollment ID: I20210405000892 |
| Provider Name | Nicole Harvey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184276834 PECOS PAC ID: 5799192936 Enrollment ID: I20210406000182 |
| Provider Name | Carliqua Spencer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235724105 PECOS PAC ID: 3577971464 Enrollment ID: I20210414000012 |
| Provider Name | Angela Otero |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649924424 PECOS PAC ID: 6406204684 Enrollment ID: I20231129000115 |
| Provider Name | Tamika Anschelle Hammond |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679279814 PECOS PAC ID: 1759737182 Enrollment ID: I20240124003857 |
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