Crossroads Psychological Associates Llc | |
10784 Hickory Ridge Rd Columbia MD 21044-3646 | |
(410) 964-0425 | |
(410) 964-0515 |
Full Name | Crossroads Psychological Associates Llc |
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Speciality | Psychologist |
Location | 10784 Hickory Ridge Rd, Columbia, Maryland |
Authorized Official Name and Position | Susan Stacy (ADMINISTRATOR) |
Authorized Official Contact | 4109640425 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Crossroads Psychological Associates Llc 10784 Hickory Ridge Rd Columbia MD 21044-3646 Ph: (410) 964-0425 | Crossroads Psychological Associates Llc 10784 Hickory Ridge Rd Columbia MD 21044-3646 Ph: (410) 964-0425 |
NPI Number | 1285814079 |
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Provider Enumeration Date | 11/08/2007 |
Last Update Date | 03/03/2010 |
Medicare PECOS PAC ID | 9830234962 |
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Medicare Enrollment ID | O20100301000669 |
Identifier | Type | State | Issuer |
---|---|---|---|
1285814079 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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103T00000X | Psychologist | (* (Not Available)) | Primary |
Provider Name | Brenda L May |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1164418380 PECOS PAC ID: 1052361318 Enrollment ID: I20050125000852 |
Provider Name | Laura K Renbaum |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1073511226 PECOS PAC ID: 9638143829 Enrollment ID: I20050609000666 |
Provider Name | David M Band |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1043316094 PECOS PAC ID: 8325003205 Enrollment ID: I20100421000586 |
Provider Name | Wanda C Caesar |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1316288699 PECOS PAC ID: 7517104318 Enrollment ID: I20130515000518 |
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