| Arise Behavioral Health | |
|
2670 Crain Hwy Ste 510 Waldorf MD 20601-2819 | |
| (301) 374-8772 | |
| (301) 374-8773 |
| Full Name | Arise Behavioral Health |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 2670 Crain Hwy Ste 510, Waldorf, Maryland |
| Authorized Official Name and Position | Ebony Joi Cross (PSYCHIATRIC NURSE PRACTITIONER) |
| Authorized Official Contact | 9194084627 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Arise Behavioral Health 2670 Crain Hwy Ste 510 Waldorf MD 20601-2819 Ph: (301) 374-8772 | Arise Behavioral Health 2670 Crain Hwy Ste 510 Waldorf MD 20601-2819 Ph: (301) 374-8772 |
| NPI Number | 1972160406 |
|---|---|
| Provider Enumeration Date | 05/21/2019 |
| Last Update Date | 02/09/2024 |
| Certification Date | 02/09/2024 |
| Medicare PECOS PAC ID | 8123445194 |
|---|---|
| Medicare Enrollment ID | O20200908000045 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972160406 | NPI | - | NPPES |
| 916017501 | Medicaid | MD |
| Provider Name | Adora N Bosah |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386109346 PECOS PAC ID: 3870836497 Enrollment ID: I20190523000836 |
| Provider Name | Ebony Joi Cross |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508303801 PECOS PAC ID: 2264703644 Enrollment ID: I20200908000063 |
| Provider Name | Traci-shara Fields |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114340676 PECOS PAC ID: 6305134115 Enrollment ID: I20211012002459 |
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