| I-matter | |
|
8511 Loch Raven Blvd Baltimore MD 21286-2302 | |
| (410) 497-5840 | |
| (410) 497-5797 |
| Full Name | I-matter |
|---|---|
| Speciality | Clinic/Center |
| Location | 8511 Loch Raven Blvd, Baltimore, Maryland |
| Authorized Official Name and Position | Alysia Barber (CEO/MEDICAL DIRECTOR) |
| Authorized Official Contact | 3054917216 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| I-matter 8511 Loch Raven Blvd Upper Level (a) Baltimore MD 21286-2302 Ph: (410) 497-5840 | I-matter 8511 Loch Raven Blvd Baltimore MD 21286-2302 Ph: (410) 497-5840 |
| NPI Number | 1316546310 |
|---|---|
| Provider Enumeration Date | 10/21/2020 |
| Last Update Date | 04/17/2023 |
| Certification Date | 04/05/2023 |
| Medicare PECOS PAC ID | 3577975051 |
|---|---|
| Medicare Enrollment ID | O20201208001679 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316546310 | NPI | - | NPPES |
| Provider Name | Cecelia Carroll |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548592314 PECOS PAC ID: 6305256082 Enrollment ID: I20201109001425 |
| Provider Name | Angela Barber |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184188930 PECOS PAC ID: 7517370547 Enrollment ID: I20210119002728 |
| Provider Name | Alysia Barber |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467122689 PECOS PAC ID: 5890108823 Enrollment ID: I20220407000047 |
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