| |
1003 W 7th St Ste 500 Frederick MD 21701-8512 | |
(301) 345-1022 | |
(301) 682-2472 |
Full Name | |
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Speciality | Clinic/Center |
Location | 1003 W 7th St Ste 500, Frederick, Maryland |
Authorized Official Name and Position | Vera Kurdian (PROGRAM DIRECTOR) |
Authorized Official Contact | 3013451022 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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16220 Frederick Rd Ste 310 Gaithersburg MD 20877-4020 Ph: (301) 345-1022 | 1003 W 7th St Ste 500 Frederick MD 21701-8512 Ph: (301) 345-1022 |
NPI Number | 1154799559 |
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Provider Enumeration Date | 09/02/2015 |
Last Update Date | 06/01/2022 |
Medicare PECOS PAC ID | 8022147933 |
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Medicare Enrollment ID | O20100602000083 |
Identifier | Type | State | Issuer |
---|---|---|---|
1154799559 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (Maryland) | Primary |
Provider Name | Craig David Washington |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1790728723 PECOS PAC ID: 9032163399 Enrollment ID: I20050309000609 |
Provider Name | Joshua B Sussal |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1922212174 PECOS PAC ID: 6204936446 Enrollment ID: I20070717000335 |
Provider Name | Alicia L Medina |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1164856043 PECOS PAC ID: 8820225766 Enrollment ID: I20140609001608 |
Provider Name | Lesly H Baugh |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1639242522 PECOS PAC ID: 2769671791 Enrollment ID: I20180425001276 |
Provider Name | Kyle B O'connor |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1487189189 PECOS PAC ID: 4981963790 Enrollment ID: I20180517001961 |
Provider Name | Jonathan D Englard |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1821538224 PECOS PAC ID: 3274892849 Enrollment ID: I20180525000770 |
Provider Name | Sierra Hartsfield |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1043631922 PECOS PAC ID: 6305105909 Enrollment ID: I20190404001473 |
Provider Name | Kimberly Hamilton-harris |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1376811463 PECOS PAC ID: 9537428925 Enrollment ID: I20191217002856 |
Provider Name | Raymond William Mclaughlin |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1598928483 PECOS PAC ID: 7719114701 Enrollment ID: I20200123000603 |
Provider Name | Michelle M Jefferson |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1316370182 PECOS PAC ID: 4385976695 Enrollment ID: I20221111001113 |
Provider Name | Wendy P Grier |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1184266959 PECOS PAC ID: 3173999588 Enrollment ID: I20221124000024 |
Provider Name | Jennifer C Cook |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1720570245 PECOS PAC ID: 1658740527 Enrollment ID: I20221229000601 |
Provider Name | Meghan E Reilly |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1295156164 PECOS PAC ID: 2365814944 Enrollment ID: I20230207003665 |
Provider Name | Jacquetta S Richardson |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1194342824 PECOS PAC ID: 0648644773 Enrollment ID: I20230313001477 |
Provider Name | Valerie A Dorsey |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1265807689 PECOS PAC ID: 8729421565 Enrollment ID: I20240208001119 |
Provider Name | Rebecca Hrabec |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1740791979 PECOS PAC ID: 1254775026 Enrollment ID: I20240229003475 |
Provider Name | Melissa Nabinett |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1881079317 PECOS PAC ID: 5991141350 Enrollment ID: I20240321003289 |
Provider Name | Summer D Patrick |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1467811174 PECOS PAC ID: 8820437585 Enrollment ID: I20240425001802 |
Provider Name | Juliet Garber |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1093473423 PECOS PAC ID: 8224479464 Enrollment ID: I20240518000055 |
Provider Name | Ryan Summers |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1124484076 PECOS PAC ID: 0941641187 Enrollment ID: I20240520000059 |
Provider Name | Margaret A Jordan |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1467935650 PECOS PAC ID: 4183066368 Enrollment ID: I20240521002111 |
Provider Name | Bridgit Sims |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1568052041 PECOS PAC ID: 7315489622 Enrollment ID: I20240605002595 |
Provider Name | Debra Thompson |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1831419100 PECOS PAC ID: 2668607946 Enrollment ID: I20240607001806 |
Provider Name | Nikiah L Wade |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1861162653 PECOS PAC ID: 5597207191 Enrollment ID: I20240611002566 |
Provider Name | Trina-michelle Rosado |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1053977645 PECOS PAC ID: 2466994975 Enrollment ID: I20240611003495 |
Provider Name | Emer Donnelly Nelson |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1790283463 PECOS PAC ID: 5496297814 Enrollment ID: I20240612003420 |
Provider Name | Paige Austin |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1528514999 PECOS PAC ID: 2466994363 Enrollment ID: I20240627001349 |
Provider Name | Raphael J Sayada |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1992451900 PECOS PAC ID: 0042754079 Enrollment ID: I20240702001100 |
Provider Name | Bonita D Reyes |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1821584905 PECOS PAC ID: 3173060704 Enrollment ID: I20240802000808 |
Provider Name | Francisco J Silva |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1609526698 PECOS PAC ID: 2668912924 Enrollment ID: I20240912003606 |
Provider Name | Samantha Schlosburg |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1710524376 PECOS PAC ID: 0840731741 Enrollment ID: I20240918004522 |
Provider Name | Allison Miles |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1124749387 PECOS PAC ID: 5092256990 Enrollment ID: I20240918004699 |
Provider Name | Tennille Craig |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1487075362 PECOS PAC ID: 3971034091 Enrollment ID: I20241001001074 |
Provider Name | Samuel B Hopkins |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1144993825 PECOS PAC ID: 9830620657 Enrollment ID: I20241003004288 |
Provider Name | Haley M Coote |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1124595525 PECOS PAC ID: 2668906017 Enrollment ID: I20241107004256 |
Provider Name | Keir D Hudson |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1942965454 PECOS PAC ID: 3173059540 Enrollment ID: I20241209002367 |
Hillcrest School Based Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1285 Hillcrest Dr, Frederick, MD 21703 Phone: 240-236-3275 Fax: 240-236-3293 | |
Premise Health Of Maryland Medical P C Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 7407 Willow Rd, Frederick, MD 21702 Phone: 301-624-5270 Fax: 334-625-4520 | |
Premise Health Of Maryland Medical P C Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 9021 Bennett Creek Blvd, Frederick, MD 21704 Phone: 240-346-3549 |