Provider Demographics
NPI:1508217449
Name:M&M BEHAVIORAL HEALTH SOLUTIONS
Entity Type:Organization
Organization Name:M&M BEHAVIORAL HEALTH SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCOY
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:410-766-6624
Mailing Address - Street 1:1406 CRAIN HWY S STE 104
Mailing Address - Street 2:
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-4086
Mailing Address - Country:US
Mailing Address - Phone:410-766-6624
Mailing Address - Fax:410-766-0240
Practice Address - Street 1:1406 CRAIN HIGHWAY SOUTH S.,
Practice Address - Street 2:STE 102, 104, 106
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-2106
Practice Address - Country:US
Practice Address - Phone:443-685-5945
Practice Address - Fax:410-766-0240
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-22
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD906103101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD455107900Medicaid