Provider Demographics
NPI:1982092490
Name:BALTIMORE COUNSELING ASSOCIATES LLC
Entity Type:Organization
Organization Name:BALTIMORE COUNSELING ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMNISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:PISCATELLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-625-4663
Mailing Address - Street 1:106 E CHASE ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21202-2604
Mailing Address - Country:US
Mailing Address - Phone:410-625-4663
Mailing Address - Fax:
Practice Address - Street 1:106 E CHASE ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21202-2604
Practice Address - Country:US
Practice Address - Phone:410-625-4663
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-06
Last Update Date:2015-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC4136102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalystGroup - Single Specialty