| Mirror Mental Health | |
|
2110 Priest Bridge Dr Ste 1 Crofton MD 21114-2472 | |
| (443) 937-7089 | |
| (443) 292-4570 |
| Full Name | Mirror Mental Health |
|---|---|
| Speciality | Psychologist |
| Location | 2110 Priest Bridge Dr Ste 1, Crofton, Maryland |
| Authorized Official Name and Position | Angie Boulware (DIRECTOR, CREDENTIALING & CONTRACT) |
| Authorized Official Contact | 8002883406 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mirror Mental Health 2110 Priest Bridge Dr Ste 1 Crofton MD 21114-2472 Ph: (443) 937-7089 | Mirror Mental Health 2110 Priest Bridge Dr Ste 1 Crofton MD 21114-2472 Ph: (443) 937-7089 |
| NPI Number | 1093289985 |
|---|---|
| Provider Enumeration Date | 01/14/2019 |
| Last Update Date | 01/14/2019 |
| Medicare PECOS PAC ID | 6002156502 |
|---|---|
| Medicare Enrollment ID | O20190320001027 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093289985 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC1900X | Psychologist - Counseling | (* (Not Available)) | Primary |
| Provider Name | Tammy M Miller |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1245580521 PECOS PAC ID: 2567725179 Enrollment ID: I20180412002596 |
| Provider Name | Athena Brooks |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356609325 PECOS PAC ID: 5294078283 Enrollment ID: I20190514002787 |
| Provider Name | Tyler R Calabrese |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1174915961 PECOS PAC ID: 0749617157 Enrollment ID: I20200225001216 |
Connected Communities For Behavioral Wellness Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2139 Espey Ct Ste 2, Crofton, MD 21114 Phone: 202-230-2374 | |
Choosing Wellness, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2139 Espey Ct Ste 2, Crofton, MD 21114 Phone: 202-230-2374 | |
Essential Outcomes, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2138 Priest Bridge Ct Ste 1, Crofton, MD 21114 Phone: 443-274-6000 | |
Holistic, Re-education, & Empowering Serices, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2305 Fairhaven Lane, Crofton, MD 21114 Phone: 202-540-0718 | |
Women's Innerfitness & Wellness Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2110 Priest Bridge Dr, Suite 4, Crofton, MD 21114 Phone: 443-569-8882 | |
Innovation Health System, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2138 Espey Ct Ste 1, Crofton, MD 21114 Phone: 443-519-7277 Fax: 443-470-7718 |