Provider Demographics
NPI:1780266775
Name:IQL BEHAVIORAL HEALTH SERVICES LLC
Entity type:Organization
Organization Name:IQL BEHAVIORAL HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCPC
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:MELTON-JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-567-6219
Mailing Address - Street 1:1003 RED PUMP RD
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-2459
Mailing Address - Country:US
Mailing Address - Phone:443-465-8934
Mailing Address - Fax:
Practice Address - Street 1:108 N BOND ST STE A
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-3533
Practice Address - Country:US
Practice Address - Phone:443-567-6219
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-28
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitationGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Multi-Specialty