Provider Demographics
NPI:1932103926
Name:CEDAR RIDGE COUNSELING CENTERS, LLC
Entity Type:Organization
Organization Name:CEDAR RIDGE COUNSELING CENTERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CLIFFORD
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:ESSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:410-552-0773
Mailing Address - Street 1:1425 LIBERTY RD
Mailing Address - Street 2:STE 208
Mailing Address - City:ELDERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:21784-6415
Mailing Address - Country:US
Mailing Address - Phone:410-552-0773
Mailing Address - Fax:410-552-0774
Practice Address - Street 1:1425 LIBERTY RD
Practice Address - Street 2:STE 208
Practice Address - City:ELDERSBURG
Practice Address - State:MD
Practice Address - Zip Code:21784-6415
Practice Address - Country:US
Practice Address - Phone:410-552-0773
Practice Address - Fax:410-552-0774
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)