| Bergand Group | |
|
1300 York Rd Ste 300 Lutherville MD 21093-6019 | |
| (410) 853-7691 | |
| (443) 519-5167 |
| Full Name | Bergand Group |
|---|---|
| Speciality | Psychiatry & Neurology - Addiction Medicine |
| Location | 1300 York Rd Ste 300, Lutherville, Maryland |
| Authorized Official Name and Position | Craig Howard Lippens (PROGRAM DIRECTOR) |
| Authorized Official Contact | 4108537691 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bergand Group 1300 York Rd Ste 300 Lutherville MD 21093-6019 Ph: (410) 853-7691 | Bergand Group 1300 York Rd Ste 300 Lutherville MD 21093-6019 Ph: (410) 853-7691 |
| NPI Number | 1013402379 |
|---|---|
| Provider Enumeration Date | 06/28/2018 |
| Last Update Date | 06/28/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013402379 | NPI | - | NPPES |
| 741082 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084A0401X | Psychiatry & Neurology - Addiction Medicine | D0023973 (Maryland) | Primary |
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Secondary |
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