Provider Demographics
NPI:1245890250
Name:BALTIMORE WOMEN'S PSYCHOLOGICAL SERVICES, LLC
Entity type:Organization
Organization Name:BALTIMORE WOMEN'S PSYCHOLOGICAL SERVICES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAINA
Authorized Official - Middle Name:LISA EMERY
Authorized Official - Last Name:AYERS-GREENIDGE
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:410-873-7357
Mailing Address - Street 1:4800 ROLAND AVE STE 301
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21210-2347
Mailing Address - Country:US
Mailing Address - Phone:410-873-7357
Mailing Address - Fax:
Practice Address - Street 1:4800 ROLAND AVE STE 301
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21210-2347
Practice Address - Country:US
Practice Address - Phone:410-873-7357
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-20
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health