| |
2205 York Rd Ste 10 Luthvle Timon MD 21093-3168 | |
(443) 845-3986 | |
Not Available |
Full Name | |
---|---|
Speciality | Counselor |
Location | 2205 York Rd Ste 10, Luthvle Timon, Maryland |
Authorized Official Name and Position | Julia Knach (OWNER) |
Authorized Official Contact | 4434709226 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
521 Brook Rd Baltimore MD 21286-5634 Ph: (443) 470-9226 | 2205 York Rd Ste 10 Luthvle Timon MD 21093-3168 Ph: (443) 845-3986 |
NPI Number | 1740865948 |
---|---|
Provider Enumeration Date | 03/10/2021 |
Last Update Date | 03/26/2024 |
Certification Date | 03/26/2024 |
Medicare PECOS PAC ID | 6507301439 |
---|---|
Medicare Enrollment ID | O20240715003642 |
Identifier | Type | State | Issuer |
---|---|---|---|
1740865948 | NPI | - | NPPES |
LC4397 | Other | MD | LCPC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
Provider Name | Julia F Knach |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1144660887 PECOS PAC ID: 0042755977 Enrollment ID: I20240729001824 |
Catherine Harrison-restelli Md Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2324 W Joppa Rd Ste 220, Luthvle Timon, MD 21093 Phone: 443-377-1764 Fax: 410-583-2949 |