| Parker Psychiatric Services, Incorporated | |
|
940 Madison Ave Ste 202 Baltimore MD 21201-2113 | |
| (410) 440-0317 | |
| (443) 434-0110 |
| Full Name | Parker Psychiatric Services, Incorporated |
|---|---|
| Speciality | Clinic/Center |
| Location | 940 Madison Ave Ste 202, Baltimore, Maryland |
| Authorized Official Name and Position | Gary Parker (CEO) |
| Authorized Official Contact | 4104400317 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Parker Psychiatric Services, Incorporated 940 Madison Ave Ste 202 Baltimore MD 21201-2113 Ph: (410) 440-0317 | Parker Psychiatric Services, Incorporated 940 Madison Ave Ste 202 Baltimore MD 21201-2113 Ph: (410) 440-0317 |
| NPI Number | 1912478900 |
|---|---|
| Provider Enumeration Date | 12/17/2018 |
| Last Update Date | 12/17/2018 |
| Medicare PECOS PAC ID | 7113322835 |
|---|---|
| Medicare Enrollment ID | O20210818002998 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912478900 | NPI | - | NPPES |
| 422901100 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Cholet K Josue |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1386834679 PECOS PAC ID: 4385720606 Enrollment ID: I20080827000166 |
| Provider Name | Adetimbo Adediran |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679922298 PECOS PAC ID: 4082902937 Enrollment ID: I20161011000053 |
| Provider Name | Jacinta Casey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821698184 PECOS PAC ID: 5395117675 Enrollment ID: I20230215000058 |
| Provider Name | Kelly Wojciechowski |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982355889 PECOS PAC ID: 5597137877 Enrollment ID: I20230215000292 |
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