| Maryland Psychological And Management Services Center, Llc | |
|
10 W Madison St # 11 Baltimore MD 21201-5239 | |
| (443) 438-7863 | |
| (443) 957-9485 |
| Full Name | Maryland Psychological And Management Services Center, Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 10 W Madison St # 11, Baltimore, Maryland |
| Authorized Official Name and Position | Durwood Whitten (SOLE PROPRIETOR) |
| Authorized Official Contact | 4434387863 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Maryland Psychological And Management Services Center, Llc 10 W Madison St # 11 Baltimore MD 21201-5239 Ph: (443) 438-7863 | Maryland Psychological And Management Services Center, Llc 10 W Madison St # 11 Baltimore MD 21201-5239 Ph: (443) 438-7863 |
| NPI Number | 1891033916 |
|---|---|
| Provider Enumeration Date | 01/24/2013 |
| Last Update Date | 01/24/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891033916 | NPI | - | NPPES |
| 052304600 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 04983 (Maryland) | Primary |
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