| Vance Mental Health Services | |
|
21 Industrial Park Dr Suite 202 F Waldorf MD 20602-2751 | |
| (301) 848-0461 | |
| (301) 885-0922 |
| Full Name | Vance Mental Health Services |
|---|---|
| Speciality | Psychologist |
| Location | 21 Industrial Park Dr, Waldorf, Maryland |
| Authorized Official Name and Position | Patricia Vance (DIRECTOR) |
| Authorized Official Contact | 3018480461 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vance Mental Health Services 21 Industrial Park Dr Suite 202 F Waldorf MD 20602-2751 Ph: (301) 848-0461 | Vance Mental Health Services 21 Industrial Park Dr Suite 202 F Waldorf MD 20602-2751 Ph: (301) 848-0461 |
| NPI Number | 1205079746 |
|---|---|
| Provider Enumeration Date | 04/14/2009 |
| Last Update Date | 06/24/2009 |
| Medicare PECOS PAC ID | 9638220759 |
|---|---|
| Medicare Enrollment ID | O20090701000530 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205079746 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 02983 (Maryland) | Primary |
| 1041C0700X | Social Worker - Clinical | 05567 (Maryland) | Secondary |
| Provider Name | Patricia Vance |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1518082478 PECOS PAC ID: 4183775299 Enrollment ID: I20090701000428 |
| Provider Name | Paul E Donato |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689799751 PECOS PAC ID: 3678739745 Enrollment ID: I20120718000640 |
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