Provider Demographics
NPI:1003501313
Name:SMB BEHAVORIAL HEALTH SERVICE, LLC
Entity Type:Organization
Organization Name:SMB BEHAVORIAL HEALTH SERVICE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PMHNP-BC
Authorized Official - Prefix:MRS
Authorized Official - First Name:SCHERRA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOARMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:667-298-6361
Mailing Address - Street 1:16A BEL AIR SOUTH PKWY STE 321
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21015-6038
Mailing Address - Country:US
Mailing Address - Phone:667-298-6361
Mailing Address - Fax:
Practice Address - Street 1:16A BEL AIR SOUTH PKWY STE 321
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21015-6038
Practice Address - Country:US
Practice Address - Phone:667-298-6361
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-11
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health