| Chesapeake Behavioral Health Center, Llc | |
|
217 Main St Suite B Reisterstown MD 21136-1213 | |
| (410) 833-0581 | |
| (410) 833-8604 |
| Full Name | Chesapeake Behavioral Health Center, Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 217 Main St, Reisterstown, Maryland |
| Authorized Official Name and Position | Lucy J. Correa-cashdollar (PRACTICE MANAGER) |
| Authorized Official Contact | 4108330581 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Chesapeake Behavioral Health Center, Llc 217 Main St Suite B Reisterstown MD 21136-1213 Ph: (410) 833-0581 | Chesapeake Behavioral Health Center, Llc 217 Main St Suite B Reisterstown MD 21136-1213 Ph: (410) 833-0581 |
| NPI Number | 1437118742 |
|---|---|
| Provider Enumeration Date | 03/23/2006 |
| Last Update Date | 08/26/2016 |
| Medicare PECOS PAC ID | 5496762155 |
|---|---|
| Medicare Enrollment ID | O20060321000555 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437118742 | NPI | - | NPPES |
| 225P | Other | MD | MEDICARE GROUP NUMBER |
| 0007543711 | Other | MD | AETNA |
| K876 | Other | MD | GHMSI & BLUE CHOICE, INC |
| 4168160 00 | Medicaid | MD | |
| 284CCH | Other | MD | CAREFIRST OF MARYLAND |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | D0020136 (Maryland) | Primary |
| Provider Name | Elsa I Correa |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1487620423 PECOS PAC ID: 2567479223 Enrollment ID: I20060321000574 |
| Provider Name | Jennifer C Correa-elkins |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154610848 PECOS PAC ID: 5597941906 Enrollment ID: I20110519000693 |
| Provider Name | Elsa Victoria Correa-deleonardo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396222907 PECOS PAC ID: 9830438670 Enrollment ID: I20190222000477 |
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