| Pyramid Walden Llc | |
|
30007 Business Center Dr Charlotte Hall MD 20622-3101 | |
| (301) 997-1300 | |
| (301) 290-0280 |
| Full Name | Pyramid Walden Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 30007 Business Center Dr, Charlotte Hall, Maryland |
| Authorized Official Name and Position | Jason Hendricks (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 8149400407 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pyramid Walden Llc 30007 Business Center Dr Charlotte Hall MD 20622-3101 Ph: (301) 997-1300 | Pyramid Walden Llc 30007 Business Center Dr Charlotte Hall MD 20622-3101 Ph: (301) 997-1300 |
| NPI Number | 1174869291 |
|---|---|
| Provider Enumeration Date | 12/18/2012 |
| Last Update Date | 04/10/2024 |
| Certification Date | 04/10/2024 |
| Medicare PECOS PAC ID | 3476797085 |
|---|---|
| Medicare Enrollment ID | O20130923000258 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174869291 | NPI | - | NPPES |
| 4214480-00 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | MH-915 (Maryland) | Primary |
| Provider Name | Barbara Ann Mielcarek |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124107008 PECOS PAC ID: 9830191014 Enrollment ID: I20070201000461 |
| Provider Name | Mary Beth Voorhees |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497733695 PECOS PAC ID: 5597081869 Enrollment ID: I20150303002525 |
Walden Behavioral Health Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 30007 Business Center Dr, Charlotte Hall, MD 20622 Phone: 301-997-1300 Fax: 301-997-1321 | |
Charles C Reel, M.d. Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 30065 Business Center Dr, Charlotte Hall, MD 20622 Phone: 301-290-0395 Fax: 301-290-0396 | |
Board Of Child Care Of The United Methodist Church, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 30049 Business Center Dr, Charlotte Hall, MD 20622 Phone: 301-884-0312 Fax: 301-274-4039 |