Provider Demographics
NPI:1073060828
Name:SAHA, ABHIK (LCPC)
Entity Type:Individual
Prefix:MR
First Name:ABHIK
Middle Name:
Last Name:SAHA
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10176 BALTIMORE NATIONAL PIKE STE 110
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-3651
Mailing Address - Country:US
Mailing Address - Phone:443-720-0090
Mailing Address - Fax:
Practice Address - Street 1:787 OELLA AVE
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21043-4727
Practice Address - Country:US
Practice Address - Phone:443-720-0090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-08
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC7342101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD119462300Medicaid