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201 International Cir Ste 230 Cockeysville MD 21030-1344 | |
| (443) 567-6091 | |
| (443) 567-6191 |
| Full Name | |
|---|---|
| Speciality | Nurse Practitioner - Psychiatric/mental Health |
| Location | 201 International Cir Ste 230, Cockeysville, Maryland |
| Authorized Official Name and Position | Patrick Mcdonald (CMO) |
| Authorized Official Contact | 4435676091 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
404 N Hickory Ave Bel Air MD 21014-3227 Ph: (410) 459-7699 | 201 International Cir Ste 230 Cockeysville MD 21030-1344 Ph: (443) 567-6091 |
| NPI Number | 1497570402 |
|---|---|
| Provider Enumeration Date | 11/15/2024 |
| Last Update Date | 12/03/2024 |
| Certification Date | 12/03/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497570402 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | (* (Not Available)) | Primary |
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