| Magellan Provider Services Of Ca Pc | |
|
8621 Robert Fulton Dr Columbia MD 21046-2620 | |
| (833) 605-0634 | |
| Not Available |
| Full Name | Magellan Provider Services Of Ca Pc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 8621 Robert Fulton Dr, Columbia, Maryland |
| Authorized Official Name and Position | Brian Frey (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 3144068632 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Magellan Provider Services Of Ca Pc 8621 Robert Fulton Dr Columbia MD 21046-2620 Ph: (833) 605-0634 | Magellan Provider Services Of Ca Pc 8621 Robert Fulton Dr Columbia MD 21046-2620 Ph: (833) 605-0634 |
| NPI Number | 1548984404 |
|---|---|
| Provider Enumeration Date | 10/03/2022 |
| Last Update Date | 10/03/2022 |
| Certification Date | 10/03/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548984404 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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