Provider Demographics
NPI:1376648618
Name:FISHBEIN PSYCHOLOGICAL ASSOCIATES, P.A.
Entity Type:Organization
Organization Name:FISHBEIN PSYCHOLOGICAL ASSOCIATES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:H
Authorized Official - Last Name:FISHBEIN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:410-521-2150
Mailing Address - Street 1:604 DUNKIRK RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21212
Mailing Address - Country:US
Mailing Address - Phone:410-521-2150
Mailing Address - Fax:410-377-3323
Practice Address - Street 1:604 DUNKIRK RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21212-2015
Practice Address - Country:US
Practice Address - Phone:410-521-2150
Practice Address - Fax:410-377-3323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-13
Last Update Date:2015-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01936103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDPVPB8164OtherAPS
MDT608OtherFEDERAL BC/BS, BLUECHOICE
MD191074OtherCOMPSYCH
MDG338OtherMARYLAND BLUE CROSS
MD2540606-00Medicaid
MD2540606-00Medicaid