| Constantly Evolving | |
|
10451 Mill Run Cir Ste 400 Owings Mills MD 21117-5594 | |
| (443) 219-8482 | |
| Not Available |
| Full Name | Constantly Evolving |
|---|---|
| Speciality | Social Worker |
| Location | 10451 Mill Run Cir Ste 400, Owings Mills, Maryland |
| Authorized Official Name and Position | Vivian K Henderson (MENTAL HEALTH THERAPIST) |
| Authorized Official Contact | 4432198482 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Constantly Evolving 10451 Mill Run Cir Ste 400 Owings Mills MD 21117-5594 Ph: (443) 219-8482 | Constantly Evolving 10451 Mill Run Cir Ste 400 Owings Mills MD 21117-5594 Ph: (443) 219-8482 |
| NPI Number | 1982296315 |
|---|---|
| Provider Enumeration Date | 02/08/2021 |
| Last Update Date | 02/08/2021 |
| Certification Date | 02/08/2021 |
| Medicare PECOS PAC ID | 1658748793 |
|---|---|
| Medicare Enrollment ID | O20221103000018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982296315 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Vivian K Henderson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083033815 PECOS PAC ID: 5991114605 Enrollment ID: I20210511000214 |
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