| University Psychological Center, Inc | |
|
21 W 25th St Baltimore MD 21218-5003 | |
| (410) 366-1717 | |
| (410) 889-4176 |
| Full Name | University Psychological Center, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 21 W 25th St, Baltimore, Maryland |
| Authorized Official Name and Position | Clark J Hudak (CEO) |
| Authorized Official Contact | 4105769191 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| University Psychological Center, Inc 21 W 25th St Baltimore MD 21218-5003 Ph: (410) 366-1717 | University Psychological Center, Inc 21 W 25th St Baltimore MD 21218-5003 Ph: (410) 366-1717 |
| NPI Number | 1841647617 |
|---|---|
| Provider Enumeration Date | 05/20/2016 |
| Last Update Date | 05/20/2016 |
| Medicare PECOS PAC ID | 4789674094 |
|---|---|
| Medicare Enrollment ID | O20230710002271 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841647617 | NPI | - | NPPES |
| Provider Name | David J Forbes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164427266 PECOS PAC ID: 6305835612 Enrollment ID: I20040511001190 |
| Provider Name | Ahmad N Khan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1538120613 PECOS PAC ID: 7012939200 Enrollment ID: I20060103000244 |
| Provider Name | Bert Nayfack |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1124051768 PECOS PAC ID: 2961578562 Enrollment ID: I20080905000174 |
| Provider Name | James D. Luciuk |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639117591 PECOS PAC ID: 2365411642 Enrollment ID: I20080916000428 |
| Provider Name | Hannah J Ong |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1922201417 PECOS PAC ID: 6901143478 Enrollment ID: I20190314001018 |
| Provider Name | Breanna Sloan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205447273 PECOS PAC ID: 0749690683 Enrollment ID: I20201109000110 |
| Provider Name | Ashley Lucas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558952689 PECOS PAC ID: 5698169779 Enrollment ID: I20220307001888 |
| Provider Name | Clark Hudak |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598786329 PECOS PAC ID: 5496778789 Enrollment ID: I20230721000331 |
| Provider Name | Bryce Hudak |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588068019 PECOS PAC ID: 9739482134 Enrollment ID: I20230721000479 |
| Provider Name | Laina Santamaria |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689320194 PECOS PAC ID: 0749642767 Enrollment ID: I20230808002259 |
| Provider Name | Adelaide Ayukegba |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750037347 PECOS PAC ID: 3870941677 Enrollment ID: I20240104002254 |
| Provider Name | Alia Merraro |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1447636014 PECOS PAC ID: 6002267929 Enrollment ID: I20240104003257 |
| Provider Name | Vivian Adaeze Imo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528651924 PECOS PAC ID: 3072965813 Enrollment ID: I20240117004217 |
| Provider Name | Robert Barnes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386114445 PECOS PAC ID: 3274979422 Enrollment ID: I20240311000006 |
| Provider Name | Brian Harris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528725983 PECOS PAC ID: 8022492297 Enrollment ID: I20240416000468 |
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