| Charm City Mental Health Practice, Llc | |
|
100 West Rd Ste 112 Towson MD 21204-2358 | |
| (443) 927-6535 | |
| (410) 828-0300 |
| Full Name | Charm City Mental Health Practice, Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 100 West Rd Ste 112, Towson, Maryland |
| Authorized Official Name and Position | Rachel Courtney Matyja (OWNER/RESIDENT AGENT) |
| Authorized Official Contact | 4439276535 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Charm City Mental Health Practice, Llc 100 West Rd Ste 112 Towson MD 21204-2358 Ph: (443) 927-6535 | Charm City Mental Health Practice, Llc 100 West Rd Ste 112 Towson MD 21204-2358 Ph: (443) 927-6535 |
| NPI Number | 1184093221 |
|---|---|
| Provider Enumeration Date | 09/18/2015 |
| Last Update Date | 10/24/2020 |
| Certification Date | 10/24/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184093221 | NPI | - | NPPES |
| LC6058 | Other | MD | LICENSED CLINICAL PROFESSIONAL COUNSELOR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | LC6058 (Maryland) | Primary |
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