Provider Demographics
NPI:1790082394
Name:ANNAPOLIS YOUTH SERVICES BUREAU
Entity Type:Organization
Organization Name:ANNAPOLIS YOUTH SERVICES BUREAU
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SASCHA
Authorized Official - Middle Name:
Authorized Official - Last Name:LIPCZENKO
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:410-626-1800
Mailing Address - Street 1:92 W WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-2432
Mailing Address - Country:US
Mailing Address - Phone:410-626-1800
Mailing Address - Fax:410-626-1922
Practice Address - Street 1:92 W WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-2432
Practice Address - Country:US
Practice Address - Phone:410-626-1800
Practice Address - Fax:410-626-1922
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ANNE ARUNDEL COUNTY COMMUNITY ACTION AGENCY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-02-16
Last Update Date:2011-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty