Neurothrive, Llc | |
1205 York Rd Ste 11 Lutherville MD 21093-6211 | |
(443) 810-9483 | |
Not Available |
Full Name | Neurothrive, Llc |
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Speciality | Psychologist |
Location | 1205 York Rd Ste 11, Lutherville, Maryland |
Authorized Official Name and Position | Mark Trullinger (OWNER) |
Authorized Official Contact | 4438109483 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Neurothrive, Llc 13941 Alderton Rd Silver Spring MD 20906-2063 Ph: () - | Neurothrive, Llc 1205 York Rd Ste 11 Lutherville MD 21093-6211 Ph: (443) 810-9483 |
NPI Number | 1063890556 |
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Provider Enumeration Date | 05/15/2015 |
Last Update Date | 04/25/2016 |
Medicare PECOS PAC ID | 4486948254 |
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Medicare Enrollment ID | O20160802003140 |
Identifier | Type | State | Issuer |
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1063890556 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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103T00000X | Psychologist | 04502 (Maryland) | Primary |
Provider Name | Kiu Eubanks Smith |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1043536709 PECOS PAC ID: 4183859275 Enrollment ID: I20131025000978 |
Provider Name | Henry E Pigott |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1619312204 PECOS PAC ID: 4284927591 Enrollment ID: I20180531000496 |
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