| Urban Trauma Counseling Center, Llc | |
|
2103 Mount Holly St Baltimore MD 21216-2430 | |
| (410) 844-0770 | |
| Not Available |
| Full Name | Urban Trauma Counseling Center, Llc |
|---|---|
| Speciality | Substance Abuse Rehabilitation Facility |
| Location | 2103 Mount Holly St, Baltimore, Maryland |
| Authorized Official Name and Position | Shinelle Oglesby (CEO/CLINICAL DIRECTOR) |
| Authorized Official Contact | 4108440770 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Urban Trauma Counseling Center, Llc 3709 Essex Rd Pikesville MD 21207-4617 Ph: (410) 960-2496 | Urban Trauma Counseling Center, Llc 2103 Mount Holly St Baltimore MD 21216-2430 Ph: (410) 844-0770 |
| NPI Number | 1144913625 |
|---|---|
| Provider Enumeration Date | 05/31/2023 |
| Last Update Date | 10/12/2023 |
| Certification Date | 10/12/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144913625 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
| 324500000X | Substance Abuse Rehabilitation Facility | (* (Not Available)) | Primary |
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