| National Pike Health Center | |
|
5411 Old Frederick Rd Suite 13 Baltimore MD 21229-2195 | |
| (410) 744-8100 | |
| (410) 744-2530 |
| Full Name | National Pike Health Center |
|---|---|
| Speciality | Counselor |
| Location | 5411 Old Frederick Rd, Baltimore, Maryland |
| Authorized Official Name and Position | Cortina Levette Darden (PROGRAM DIRECTOR) |
| Authorized Official Contact | 4107448100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| National Pike Health Center 5411 Old Frederick Rd Suite 13 Baltimore MD 21229-2195 Ph: (410) 744-8100 | National Pike Health Center 5411 Old Frederick Rd Suite 13 Baltimore MD 21229-2195 Ph: (410) 744-8100 |
| NPI Number | 1548460181 |
|---|---|
| Provider Enumeration Date | 07/23/2007 |
| Last Update Date | 01/12/2015 |
| Medicare PECOS PAC ID | 7113254988 |
|---|---|
| Medicare Enrollment ID | O20190816001393 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548460181 | NPI | - | NPPES |
| 781204300 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 10075 (Maryland) | Primary |
| Provider Name | Ram K Raheja |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1629030226 PECOS PAC ID: 9032163563 Enrollment ID: I20050308000984 |
| Provider Name | Oladipo O Olaleye |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467888529 PECOS PAC ID: 3870878531 Enrollment ID: I20170320000871 |
| Provider Name | Tajudeen Omodeoye |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356817373 PECOS PAC ID: 9537402391 Enrollment ID: I20190517002182 |
| Provider Name | Telisa Michelle Hickson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700369956 PECOS PAC ID: 4385971654 Enrollment ID: I20190808002873 |
| Provider Name | Tawanna Tilghman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477014033 PECOS PAC ID: 1153658398 Enrollment ID: I20190809001447 |
| Provider Name | Chayla Fleming |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215498043 PECOS PAC ID: 2466789631 Enrollment ID: I20190809002429 |
| Provider Name | Icia Ragsdale |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609375351 PECOS PAC ID: 5193053643 Enrollment ID: I20190822001361 |
| Provider Name | Sharelle A Hill |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790070795 PECOS PAC ID: 5597085654 Enrollment ID: I20200116000063 |
| Provider Name | Jennifer Serene |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053734624 PECOS PAC ID: 4789012071 Enrollment ID: I20200320000306 |
| Provider Name | Elana Dorfman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306318761 PECOS PAC ID: 6305277112 Enrollment ID: I20200512000616 |
| Provider Name | Darlene Griffin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962099077 PECOS PAC ID: 0143623355 Enrollment ID: I20210726002998 |
| Provider Name | Cheryl Bryant |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770249435 PECOS PAC ID: 3173916426 Enrollment ID: I20220209000035 |
| Provider Name | Sarah E Balogh |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427705557 PECOS PAC ID: 7719364389 Enrollment ID: I20220520000081 |
| Provider Name | Steve Fabius |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1760950497 PECOS PAC ID: 7416284757 Enrollment ID: I20240603002096 |
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