| Mendelis Mental Health Center Llc | |
|
11315 Pembrooke Sq Ste 112 Waldorf MD 20603-4806 | |
| (301) 638-5001 | |
| (301) 638-5003 |
| Full Name | Mendelis Mental Health Center Llc |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 11315 Pembrooke Sq Ste 112, Waldorf, Maryland |
| Authorized Official Name and Position | Peter S Mendelis (OWNER) |
| Authorized Official Contact | 3016385001 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mendelis Mental Health Center Llc 11315 Pembrooke Sq Ste 112 Waldorf MD 20603-4806 Ph: (301) 638-5001 | Mendelis Mental Health Center Llc 11315 Pembrooke Sq Ste 112 Waldorf MD 20603-4806 Ph: (301) 638-5001 |
| NPI Number | 1053408377 |
|---|---|
| Provider Enumeration Date | 10/06/2006 |
| Last Update Date | 11/15/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053408377 | NPI | - | NPPES |
| 546610500 | Medicaid | MD | |
| 950006501 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 12909 (Maryland) | Secondary |
| 2084P0800X | Psychiatry & Neurology - Psychiatry | D0025586 (Maryland) | Primary |
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