Provider Demographics
NPI:1134221971
Name:JOPPA CORNERS MENTAL HEALTH SERVICES
Entity type:Organization
Organization Name:JOPPA CORNERS MENTAL HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:STOLTZFUS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-C
Authorized Official - Phone:410-627-5927
Mailing Address - Street 1:5900 MORGANS WAY
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21801-3121
Mailing Address - Country:US
Mailing Address - Phone:410-627-5927
Mailing Address - Fax:410-548-4253
Practice Address - Street 1:9533 BELAIR RD
Practice Address - Street 2:SUITE 201
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21236-1563
Practice Address - Country:US
Practice Address - Phone:410-248-3338
Practice Address - Fax:410-248-3339
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD103811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty