| Community Behavioral Health, Llc | |
|
426 Dorchester Ave Cambridge MD 21613-2446 | |
| (844) 224-5264 | |
| (888) 509-0010 |
| Full Name | Community Behavioral Health, Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 426 Dorchester Ave, Cambridge, Maryland |
| Authorized Official Name and Position | Niranjan Jani (CHIEF ADMINISTRATOR) |
| Authorized Official Contact | 4439449605 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Behavioral Health, Llc 106 Lee St Salisbury MD 21804-5938 Ph: (443) 944-9605 | Community Behavioral Health, Llc 426 Dorchester Ave Cambridge MD 21613-2446 Ph: (844) 224-5264 |
| NPI Number | 1215275466 |
|---|---|
| Provider Enumeration Date | 01/23/2013 |
| Last Update Date | 02/23/2016 |
| Medicare PECOS PAC ID | 2567693849 |
|---|---|
| Medicare Enrollment ID | O20140429000721 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215275466 | NPI | - | NPPES |
| 4214455-01 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | D0037205 (Maryland) | Primary |
| Provider Name | Sushma N Jani |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1225095714 PECOS PAC ID: 1355349457 Enrollment ID: I20061128000569 |
| Provider Name | Lesley Todd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205822053 PECOS PAC ID: 9234239310 Enrollment ID: I20070703000519 |
| Provider Name | Brenda C Scribner |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1699839076 PECOS PAC ID: 4688724289 Enrollment ID: I20090602000316 |
| Provider Name | Patti Dudley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356547590 PECOS PAC ID: 3072794916 Enrollment ID: I20110224000575 |
| Provider Name | Millicent M Handy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841626561 PECOS PAC ID: 9739314337 Enrollment ID: I20131107001327 |
| Provider Name | Stephanie Kay Dudley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235487059 PECOS PAC ID: 5294037594 Enrollment ID: I20160104001241 |
| Provider Name | Lashawanda Leslie-bulter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003316332 PECOS PAC ID: 7416299474 Enrollment ID: I20190424000240 |
| Provider Name | Suni N Jani |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1053671313 PECOS PAC ID: 4688980451 Enrollment ID: I20190617002076 |
| Provider Name | Jordan Uhden |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205329869 PECOS PAC ID: 3971914151 Enrollment ID: I20201118002735 |
| Provider Name | Aisha Siddiqa |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1881145837 PECOS PAC ID: 3870943046 Enrollment ID: I20231229002427 |
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