Provider Demographics
NPI:1649086729
Name:PRODUCTIVE PSYCH LLC
Entity type:Organization
Organization Name:PRODUCTIVE PSYCH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NICKOLAUS
Authorized Official - Middle Name:
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-C
Authorized Official - Phone:443-970-2511
Mailing Address - Street 1:16A BEL AIR SOUTH PKWY STE 330
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21015-6038
Mailing Address - Country:US
Mailing Address - Phone:410-656-9010
Mailing Address - Fax:
Practice Address - Street 1:16A BEL AIR SOUTH PKWY STE 330
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21015-6038
Practice Address - Country:US
Practice Address - Phone:410-656-9010
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-04
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty