Provider Demographics
NPI:1184909780
Name:CONSULTATION & CRISIS INTERVENTION ASSOCIATES, LLC
Entity type:Organization
Organization Name:CONSULTATION & CRISIS INTERVENTION ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:RAHSAAN
Authorized Official - Middle Name:LATEEF
Authorized Official - Last Name:LINDSEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:443-849-2369
Mailing Address - Street 1:6565 N CHARLES ST
Mailing Address - Street 2:PPE# 211
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21204-6800
Mailing Address - Country:US
Mailing Address - Phone:443-849-2369
Mailing Address - Fax:443-849-2248
Practice Address - Street 1:6565 N CHARLES ST
Practice Address - Street 2:PPE# 211
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21204-6800
Practice Address - Country:US
Practice Address - Phone:443-849-2369
Practice Address - Fax:443-849-2248
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-14
Last Update Date:2011-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD04153103TC0700X
MD04668103TC0700X
MD04535103TC0700X
MDH00596342084P0800X
MDD00365352084P0800X
MDD00636872084P0800X
MDD00695962084P0800X
MDD00724162084P0800X
MDH00721942084P0800X
MDD00651202084P0800X
MDD00594492084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty