Provider Demographics
NPI:1336297811
Name:COUNSELING CENTERS OF MARYLAND
Entity Type:Organization
Organization Name:COUNSELING CENTERS OF MARYLAND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:L
Authorized Official - Last Name:GEHRKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-356-8260
Mailing Address - Street 1:9199 REISTERSTOWN RD.
Mailing Address - Street 2:105-B
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-4520
Mailing Address - Country:US
Mailing Address - Phone:410-356-8260
Mailing Address - Fax:410-356-8299
Practice Address - Street 1:9199 REISTERSTOWN RD.
Practice Address - Street 2:105-B
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-4520
Practice Address - Country:US
Practice Address - Phone:410-356-8260
Practice Address - Fax:410-356-8299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2008-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD565LMedicare PIN