Provider Demographics
NPI:1225005580
Name:EVERLY, HILDRETH & PLATMAN BEHAVIORAL SERVICES, LLC
Entity Type:Organization
Organization Name:EVERLY, HILDRETH & PLATMAN BEHAVIORAL SERVICES, LLC
Other - Org Name:EHP BEHAVIORAL SERVICES, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MATT
Authorized Official - Middle Name:J
Authorized Official - Last Name:KRAWCZYK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-933-9000
Mailing Address - Street 1:1105 N POINT BLVD STE 321
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21224-3472
Mailing Address - Country:US
Mailing Address - Phone:410-517-7060
Mailing Address - Fax:443-407-2942
Practice Address - Street 1:8114 SANDPIPER CIRCLE
Practice Address - Street 2:SUITE 215
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21236-5902
Practice Address - Country:US
Practice Address - Phone:410-933-9000
Practice Address - Fax:410-933-0125
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-07
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC1222101YM0800X
MDLC6057101YM0800X
101YP2500X, 103TC0700X, 103TC1900X, 1041C0700X, 363LP0808X, 364SP0808X
MD04877103TC0700X
MDD00668522084P0800X, 2084P0800X
MDR121651363LP0808X
MDR188329363LP0808X
MDR060028364SP0809X
MDR032121364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental HealthGroup - Multi-Specialty
No364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, AdultGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD220281600Medicaid
MD148251300Medicaid
MDKN76Medicare PIN