Provider Demographics
NPI:1912543091
Name:TRANSCEND COUNSELING GROUP
Entity Type:Organization
Organization Name:TRANSCEND COUNSELING GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SHIP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-205-5364
Mailing Address - Street 1:1234 FOUR WINDS WAY
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21221-6081
Mailing Address - Country:US
Mailing Address - Phone:443-326-0448
Mailing Address - Fax:443-200-0224
Practice Address - Street 1:7800 WISE AVE
Practice Address - Street 2:
Practice Address - City:DUNDALK
Practice Address - State:MD
Practice Address - Zip Code:21222-3338
Practice Address - Country:US
Practice Address - Phone:410-205-5364
Practice Address - Fax:443-200-0224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-22
Last Update Date:2019-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD511050500Medicaid