| Crescent Behavioral Health Clinic, Llc | |
|
1208 E Churchville Rd Ste 200 Bel Air MD 21014-3484 | |
| (410) 417-6315 | |
| Not Available |
| Full Name | Crescent Behavioral Health Clinic, Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 1208 E Churchville Rd Ste 200, Bel Air, Maryland |
| Authorized Official Name and Position | Adeel Nasir (CEO/OWNER) |
| Authorized Official Contact | 4104176315 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Crescent Behavioral Health Clinic, Llc 520 Upper Chesapeake Dr Ste 208 Bel Air MD 21014-4392 Ph: () - | Crescent Behavioral Health Clinic, Llc 1208 E Churchville Rd Ste 200 Bel Air MD 21014-3484 Ph: (410) 417-6315 |
| NPI Number | 1902522477 |
|---|---|
| Provider Enumeration Date | 10/17/2022 |
| Last Update Date | 10/17/2022 |
| Certification Date | 10/17/2022 |
| Medicare PECOS PAC ID | 8123473642 |
|---|---|
| Medicare Enrollment ID | O20231018001284 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902522477 | NPI | - | NPPES |
| 1699061762 | Other | DE | BEHAVIORAL HEALTH |
| 1699061762 | Medicaid | DE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Adeel Nasir |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1699061762 PECOS PAC ID: 2860792793 Enrollment ID: I20160808000261 |
| Provider Name | Shazia Khan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1295962108 PECOS PAC ID: 1052554458 Enrollment ID: I20240125002015 |
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