| Bayside Therapy, Pc | |
|
8835 Chesapeake Avenue North Beach MD 20714 | |
| (301) 399-4696 | |
| (410) 741-3047 |
| Full Name | Bayside Therapy, Pc |
|---|---|
| Speciality | Counselor |
| Location | 8835 Chesapeake Avenue, North Beach, Maryland |
| Authorized Official Name and Position | Martha Kimberly Kesler (CEO) |
| Authorized Official Contact | 3013994696 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bayside Therapy, Pc Po Box 762 North Beach MD 20714-0762 Ph: (301) 399-4696 | Bayside Therapy, Pc 8835 Chesapeake Avenue North Beach MD 20714 Ph: (301) 399-4696 |
| NPI Number | 1124282371 |
|---|---|
| Provider Enumeration Date | 07/17/2008 |
| Last Update Date | 09/21/2023 |
| Certification Date | 09/21/2023 |
| Medicare PECOS PAC ID | 0143662007 |
|---|---|
| Medicare Enrollment ID | O20240523000235 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124282371 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 2600 (Maryland) | Primary |
| Provider Name | Martha K Kesler |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1720264385 PECOS PAC ID: 1052753910 Enrollment ID: I20240523001910 |
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