Provider Demographics
NPI:1770257651
Name:NEDA KAVEH LLC
Entity Type:Organization
Organization Name:NEDA KAVEH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SONYA
Authorized Official - Middle Name:NEDA
Authorized Official - Last Name:KAVEH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-428-4099
Mailing Address - Street 1:8084 BALTIMORE NATIONAL PIKE
Mailing Address - Street 2:SUITE 3210 #275
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21043
Mailing Address - Country:US
Mailing Address - Phone:410-428-4099
Mailing Address - Fax:
Practice Address - Street 1:5052 DORSEY HALL DR STE 102
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-7797
Practice Address - Country:US
Practice Address - Phone:410-428-4099
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-04
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty