Provider Demographics
NPI:1043658768
Name:CENTER FOR PROGRESSIVE LEARNING INC
Entity Type:Organization
Organization Name:CENTER FOR PROGRESSIVE LEARNING INC
Other - Org Name:FIRST STEP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MS
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:HENDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-581-7800
Mailing Address - Street 1:500 REDLAND CT
Mailing Address - Street 2:SUITE 204
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-3264
Mailing Address - Country:US
Mailing Address - Phone:410-581-7800
Mailing Address - Fax:410-581-0036
Practice Address - Street 1:10400 RIDGLAND RD
Practice Address - Street 2:SUITE 1
Practice Address - City:COCKEYSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21030-2715
Practice Address - Country:US
Practice Address - Phone:410-628-6120
Practice Address - Fax:410-628-0953
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-05
Last Update Date:2016-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD421932501Medicaid