| Carroll County Youth Service Bureau, Inc. | |
|
59 Kate Wagner Rd. Westminster MD 21157 | |
| (410) 848-2500 | |
| (410) 876-3016 |
| Full Name | Carroll County Youth Service Bureau, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 59 Kate Wagner Rd., Westminster, Maryland |
| Authorized Official Name and Position | Lynn Davis (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 4432448649 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Carroll County Youth Service Bureau, Inc. 59 Kate Wagner Rd Westminster MD 21157-6957 Ph: (410) 848-2500 | Carroll County Youth Service Bureau, Inc. 59 Kate Wagner Rd. Westminster MD 21157 Ph: (410) 848-2500 |
| NPI Number | 1710042924 |
|---|---|
| Provider Enumeration Date | 12/27/2006 |
| Last Update Date | 02/15/2023 |
| Certification Date | 02/15/2023 |
| Medicare PECOS PAC ID | 2365417052 |
|---|---|
| Medicare Enrollment ID | O20040826001093 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710042924 | NPI | - | NPPES |
| 615501400 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 12225 (Maryland) | Primary |
| Provider Name | Angela E Chmar |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912063843 PECOS PAC ID: 6103950910 Enrollment ID: I20100816000839 |
| Provider Name | Damian Ayichi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790111532 PECOS PAC ID: 0648409417 Enrollment ID: I20140128001005 |
| Provider Name | Janna S Cleary |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982039301 PECOS PAC ID: 3072744507 Enrollment ID: I20140327000092 |
| Provider Name | Tiffany Nichole Ellison Masimore |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346421716 PECOS PAC ID: 5193049278 Enrollment ID: I20150120001578 |
| Provider Name | Brandy E Day |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962688382 PECOS PAC ID: 6608161864 Enrollment ID: I20160826001127 |
| Provider Name | Sandy Denise Hansborough |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609164631 PECOS PAC ID: 2466733985 Enrollment ID: I20161221000870 |
| Provider Name | Carla E Trump |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841317898 PECOS PAC ID: 3072868553 Enrollment ID: I20180625002650 |
| Provider Name | Phoebe Antoinette Underwood-davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457844722 PECOS PAC ID: 6800148123 Enrollment ID: I20181015000317 |
| Provider Name | Terri L Wise |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326434382 PECOS PAC ID: 6800225780 Enrollment ID: I20200327000607 |
| Provider Name | Hollie E Cushen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427613082 PECOS PAC ID: 9436520236 Enrollment ID: I20230113000126 |
Sheppard Pratt Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 288 E Green St Bldg Ab, Westminster, MD 21157 Phone: 410-876-3007 Fax: 410-751-7797 | |
Ebbs And Flows Healing Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1511 Stone Rd, Westminster, MD 21158 Phone: 443-244-0263 | |
Envision Hope Therapy, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1819 Bollinger Rd, Westminster, MD 21157 Phone: 410-227-8539 | |
Villa Maria Of Caroll County Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 255 Clifton Blvd, Suite 302, Westminster, MD 21157 Phone: 410-848-2037 | |
People Encouraging & Enhancing Lives, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 280 E Main St Ste 100, Westminster, MD 21157 Phone: 410-751-3857 | |
Choice Points Counseling, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 970 Tara Oaks Ct, Westminster, MD 21157 Phone: 443-340-2011 | |
Broad Place, Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 902 Washington Rd Ste G, Westminster, MD 21157 Phone: 240-360-3693 Fax: 443-405-7237 |