Provider Demographics
NPI:1578238481
Name:THE COTTAGE, MENTAL HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:THE COTTAGE, MENTAL HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FNP, PMHNP
Authorized Official - Prefix:MS
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:SHAW
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:443-295-3561
Mailing Address - Street 1:5000 THAYER CTR STE C
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21550-1139
Mailing Address - Country:US
Mailing Address - Phone:443-295-3561
Mailing Address - Fax:
Practice Address - Street 1:5000 THAYER CTR STE C
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:MD
Practice Address - Zip Code:21550-1139
Practice Address - Country:US
Practice Address - Phone:443-295-3561
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-12
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty