| Jhu - Mental Health Counselor | |
|
1029 E Baltimore St Baltimore MD 21202-4705 | |
| (410) 675-7500 | |
| Not Available |
| Full Name | Jhu - Mental Health Counselor |
|---|---|
| Speciality | Counselor |
| Location | 1029 E Baltimore St, Baltimore, Maryland |
| Authorized Official Name and Position | Shavonda L Keating (DIRECTOR PEU) |
| Authorized Official Contact | 4109336430 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jhu - Mental Health Counselor 6201 Greenleigh Ave Middle River MD 21220-2004 Ph: (410) 933-6423 | Jhu - Mental Health Counselor 1029 E Baltimore St Baltimore MD 21202-4705 Ph: (410) 675-7500 |
| NPI Number | 1841971751 |
|---|---|
| Provider Enumeration Date | 07/25/2023 |
| Last Update Date | 11/03/2023 |
| Certification Date | 11/03/2023 |
| Medicare PECOS PAC ID | 1052223229 |
|---|---|
| Medicare Enrollment ID | O20240108003250 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841971751 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Lisa Sarvina Hanks |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1609166032 PECOS PAC ID: 9739531781 Enrollment ID: I20240116001907 |
| Provider Name | Richard Donowitz |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1437279775 PECOS PAC ID: 4385097286 Enrollment ID: I20240126002685 |
| Provider Name | Shannon Reed |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1992244925 PECOS PAC ID: 3971956764 Enrollment ID: I20240129001266 |
| Provider Name | Muhammad Waqas |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1275161952 PECOS PAC ID: 6002269644 Enrollment ID: I20240130002819 |
| Provider Name | Sharon Henderson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1265891568 PECOS PAC ID: 2163865528 Enrollment ID: I20240213002406 |
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