Provider Demographics
NPI:1811778756
Name:BAYFRONT BEHAVIORAL HEALTH, LLC
Entity type:Organization
Organization Name:BAYFRONT BEHAVIORAL HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KELSEY
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:WOODS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:410-967-5381
Mailing Address - Street 1:10227 GLOBE DR
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-2111
Mailing Address - Country:US
Mailing Address - Phone:410-967-5381
Mailing Address - Fax:
Practice Address - Street 1:10227 GLOBE DR
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-2111
Practice Address - Country:US
Practice Address - Phone:410-967-5381
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-06
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty