| The Care Group At Safe Harbor, Llc | |
|
1208 E Churchville Rd Ste 300 Bel Air MD 21014-3442 | |
| (410) 893-4600 | |
| (443) 640-4358 |
| Full Name | The Care Group At Safe Harbor, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 1208 E Churchville Rd, Bel Air, Maryland |
| Authorized Official Name and Position | Staci N Scoggin (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 4108934600 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Care Group At Safe Harbor, Llc 1208 E. Churchville Road Suite 300 Bel Air MD 21014 Ph: (410) 893-4600 | The Care Group At Safe Harbor, Llc 1208 E Churchville Rd Ste 300 Bel Air MD 21014-3442 Ph: (410) 893-4600 |
| NPI Number | 1629471958 |
|---|---|
| Provider Enumeration Date | 10/01/2014 |
| Last Update Date | 03/08/2017 |
| Medicare PECOS PAC ID | 8426372145 |
|---|---|
| Medicare Enrollment ID | O20150128000804 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629471958 | NPI | - | NPPES |
| 3102809 | Medicaid | NH | |
| 003403098 | Medicaid | DE | |
| 20280710 | Medicaid | IN | |
| Q014476 | Medicaid | TN | |
| 103054509 | Medicaid | PA | |
| 387081 | Other | MD | MEDICARE PTAN |
| 500701703 | Medicaid | OR | |
| 783706200 | Medicaid | MD |
| Provider Name | William R Walls |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093861502 PECOS PAC ID: 9436171121 Enrollment ID: I20051221000996 |
| Provider Name | Joan M Jones |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588845234 PECOS PAC ID: 8426221060 Enrollment ID: I20111027000305 |
| Provider Name | Judie Thompson Stokes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568659555 PECOS PAC ID: 9830310382 Enrollment ID: I20141027000143 |
| Provider Name | Marina Gethers |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992177851 PECOS PAC ID: 8921308362 Enrollment ID: I20151208000030 |
| Provider Name | Jennifer Maxfield Decarlo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376590414 PECOS PAC ID: 3678865292 Enrollment ID: I20160630000175 |
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