Mr Devon Anthony Blackwood, LCADC | |
100 Owings Court, Ste 8, Reisterstown, MD 21136 | |
(410) 526-7100 | |
(410) 526-7138 |
Full Name | Mr Devon Anthony Blackwood |
---|---|
Gender | Male |
Speciality | Counselor - Addiction (substance Use Disorder) |
Location | 100 Owings Court, Reisterstown, Maryland |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1336225077 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YA0400X | Counselor - Addiction (substance Use Disorder) | LCA305 (Maryland) | Primary |
Entity Name | Snlj Outpatient Care Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1457162190 PECOS PAC ID: 2769903459 Enrollment ID: O20250311001207 |
Mailing Address | Practice Location Address |
---|---|
Mr Devon Anthony Blackwood, LCADC 10400 Ridgland Road, Ste 1, Cockeysville, MD 21030 Ph: (410) 628-6120 | Mr Devon Anthony Blackwood, LCADC 100 Owings Court, Ste 8, Reisterstown, MD 21136 Ph: (410) 526-7100 |
Ilana Meiller, LCPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 37 Main St, Reisterstown, MD 21136 Phone: 410-526-7882 | |
Leah Johnson, Counselor Medicare: Not Enrolled in Medicare Practice Location: 100 Owings Ct Ste 5, Reisterstown, MD 21136 Phone: 443-610-4425 | |
Doreen Scott, LCPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 100 Owings Ct, Suite 8, Reisterstown, MD 21136 Phone: 410-526-7100 | |
Tracy Brenton, LCPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 14450 Hanover Pike, Reisterstown, MD 21136 Phone: 410-569-9497 Fax: 410-569-0094 | |
Jenna Shuman, LGPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 37 Main St, Reisterstown, MD 21136 Phone: 410-526-7882 | |
Joshua Mandell, LGPC Counselor Medicare: Medicare Enrolled Practice Location: 37 Main St, Reisterstown, MD 21136 Phone: 410-812-5623 | |
Mrs. Marsha Ann Swilley, LCPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 520 Education Way, Reisterstown, MD 21136 Phone: 410-526-4888 |