Provider Demographics
NPI:1194016980
Name:BEHAVIORAL INTERFACE
Entity Type:Organization
Organization Name:BEHAVIORAL INTERFACE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-C
Authorized Official - Phone:410-664-0999
Mailing Address - Street 1:3000 DRUID PARK DR
Mailing Address - Street 2:SUITE 2A
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215-7848
Mailing Address - Country:US
Mailing Address - Phone:410-664-0999
Mailing Address - Fax:410-664-0699
Practice Address - Street 1:3000 DRUID PARK DR
Practice Address - Street 2:SUITE 2A
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-7848
Practice Address - Country:US
Practice Address - Phone:410-664-0999
Practice Address - Fax:410-664-0699
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-27
Last Update Date:2013-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD11901101Y00000X, 104100000X
NY049197104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty