Provider Demographics
NPI:1013196120
Name:EASLEY AND ASSOCIATES LLC
Entity Type:Organization
Organization Name:EASLEY AND ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:J
Authorized Official - Last Name:EASLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-971-1371
Mailing Address - Street 1:123 HERITAGE LN
Mailing Address - Street 2:
Mailing Address - City:SYKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21784-9418
Mailing Address - Country:US
Mailing Address - Phone:410-971-1371
Mailing Address - Fax:410-549-0600
Practice Address - Street 1:507 W CHESAPEAKE AVE
Practice Address - Street 2:509
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-4345
Practice Address - Country:US
Practice Address - Phone:443-519-5752
Practice Address - Fax:410-549-0600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-25
Last Update Date:2014-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD094651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD405288900Medicaid