| Upper Bay Counseling & Support Services, Inc. | |
|
200 Booth Street Elkton MD 21921 | |
| (410) 996-5104 | |
| (410) 996-5197 |
| Full Name | Upper Bay Counseling & Support Services, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 200 Booth Street, Elkton, Maryland |
| Authorized Official Name and Position | Suanne Blumberg (CEO) |
| Authorized Official Contact | 4109965104 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Upper Bay Counseling & Support Services, Inc. 200 Booth Street Elkton MD 21921 Ph: (410) 996-5104 | Upper Bay Counseling & Support Services, Inc. 200 Booth Street Elkton MD 21921 Ph: (410) 996-5104 |
| NPI Number | 1316912652 |
|---|---|
| Provider Enumeration Date | 02/21/2006 |
| Last Update Date | 07/14/2021 |
| Certification Date | 07/14/2021 |
| Medicare PECOS PAC ID | 3971405085 |
|---|---|
| Medicare Enrollment ID | O20040121000129 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316912652 | NPI | - | NPPES |
| 922801200 | Medicaid | MD | |
| 922500500 | Other | MD | MEDICAID INTENSIVE CASE M |
| 922900100 | Other | MD | MEDICAID REHAB |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Gabrielle Manske |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306867346 PECOS PAC ID: 0446240311 Enrollment ID: I20040513000542 |
| Provider Name | Deborah Dalrymple |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396836128 PECOS PAC ID: 8426149634 Enrollment ID: I20070802000140 |
| Provider Name | Natalie Hart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851553911 PECOS PAC ID: 0840365318 Enrollment ID: I20080818000633 |
| Provider Name | Carolyn J King |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164673034 PECOS PAC ID: 0042370579 Enrollment ID: I20081113000605 |
| Provider Name | Laura G Tarte |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073663720 PECOS PAC ID: 7113087214 Enrollment ID: I20081119000488 |
| Provider Name | Paul A. Gianakon |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1578698486 PECOS PAC ID: 4183784887 Enrollment ID: I20081126000228 |
| Provider Name | Ralph D Scoville |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1669498168 PECOS PAC ID: 0345305868 Enrollment ID: I20090218000007 |
| Provider Name | Rebecca A Kiersznowski |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437201019 PECOS PAC ID: 9739205832 Enrollment ID: I20100927000522 |
| Provider Name | Robert E Wilson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1386794519 PECOS PAC ID: 4688867187 Enrollment ID: I20101015001082 |
| Provider Name | Susan G Robbins |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861722597 PECOS PAC ID: 2264616630 Enrollment ID: I20110408000255 |
| Provider Name | Laurie E Scheidle |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1801184171 PECOS PAC ID: 4486826849 Enrollment ID: I20111006000317 |
| Provider Name | Karen Sue Suetterlein |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1922369784 PECOS PAC ID: 5193976546 Enrollment ID: I20121112000185 |
| Provider Name | Lateshia Jackson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063840262 PECOS PAC ID: 5799916011 Enrollment ID: I20140328001405 |
| Provider Name | Ngozi T Chiekwu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427396373 PECOS PAC ID: 1355574468 Enrollment ID: I20140425000244 |
| Provider Name | Allan Berkowitz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1720130982 PECOS PAC ID: 7517182769 Enrollment ID: I20140702001793 |
| Provider Name | Cynthia B Reagle |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194129130 PECOS PAC ID: 0244545028 Enrollment ID: I20150824000924 |
| Provider Name | Hina Aamir |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1376777979 PECOS PAC ID: 0143524843 Enrollment ID: I20160201000402 |
| Provider Name | Julia K Kilduff |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487095840 PECOS PAC ID: 6002195427 Enrollment ID: I20161108000027 |
| Provider Name | Seth Crossan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336539881 PECOS PAC ID: 8820314636 Enrollment ID: I20161114000032 |
| Provider Name | Courtnee A Wright |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851772727 PECOS PAC ID: 7517224967 Enrollment ID: I20171120003572 |
| Provider Name | Michelle W Sayre |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538213319 PECOS PAC ID: 0941560999 Enrollment ID: I20180212002483 |
| Provider Name | Shneur Z Marshall |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063889889 PECOS PAC ID: 1355689019 Enrollment ID: I20190205002993 |
| Provider Name | Kwabena Owusu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215580816 PECOS PAC ID: 6305177031 Enrollment ID: I20191011000029 |
| Provider Name | Margaret Coen Rollins |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407193212 PECOS PAC ID: 5698109197 Enrollment ID: I20191216001398 |
| Provider Name | Belkys Sanchez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104388966 PECOS PAC ID: 6608204318 Enrollment ID: I20200311002194 |
| Provider Name | Michelle Shaneyfelt-jarzynski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912631813 PECOS PAC ID: 0345692513 Enrollment ID: I20240124000109 |
| Provider Name | Melinda Campbell |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1518122399 PECOS PAC ID: 6709222821 Enrollment ID: I20240312002322 |
| Provider Name | Abigail Doreen Miller |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1669008033 PECOS PAC ID: 7214373166 Enrollment ID: I20240313003425 |
| Provider Name | Kerry Kathleen Mccommons |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1780914796 PECOS PAC ID: 6204273642 Enrollment ID: I20240321001675 |
| Provider Name | Cynthia Ann Edwards |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1821428046 PECOS PAC ID: 6002250198 Enrollment ID: I20240416003060 |
| Provider Name | John Backert |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1750830170 PECOS PAC ID: 0143669291 Enrollment ID: I20240422002923 |
Reset, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 203 Buttonwoods Rd, Elkton, MD 21921 Phone: 443-822-2446 Fax: 443-350-9769 | |
Brantwood Fs Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1190 Augustine Herman Hwy, Elkton, MD 21921 Phone: 443-655-5116 | |
Ashley Addiction Treatment Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 111 W High St, Elkton, MD 21921 Phone: 443-760-3620 Fax: 443-371-2638 | |
Union Neurology Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 111 W High St Ste 207, Elkton, MD 21921 Phone: 410-398-2436 | |
Kemether & Associates, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 205 E Main St, Elkton, MD 21921 Phone: 410-920-2309 | |
Cecil County Infants & Toddlers Program Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 201 Booth St, Elkton, MD 21921 Phone: 410-996-5444 | |
Union Social Workers Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 111 W High St, Suite 204, Elkton, MD 21921 Phone: 410-620-0008 Fax: 410-620-1999 |