| Cope Of Upper Marlboro, Llc | |
|
11111 Lochton St Upper Marlboro MD 20774-1529 | |
| (301) 333-3660 | |
| Not Available |
| Full Name | Cope Of Upper Marlboro, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 11111 Lochton St, Upper Marlboro, Maryland |
| Authorized Official Name and Position | Ruby Mae Jones (OWNER/MANAGING MEMBER) |
| Authorized Official Contact | 3013333660 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cope Of Upper Marlboro, Llc 11111 Lochton St Upper Marlboro MD 20774-1529 Ph: (301) 333-3660 | Cope Of Upper Marlboro, Llc 11111 Lochton St Upper Marlboro MD 20774-1529 Ph: (301) 333-3660 |
| NPI Number | 1497589634 |
|---|---|
| Provider Enumeration Date | 08/29/2024 |
| Last Update Date | 09/10/2024 |
| Certification Date | 09/10/2024 |
| Medicare PECOS PAC ID | 0042751133 |
|---|---|
| Medicare Enrollment ID | O20240917000391 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497589634 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Ruby Mae Jones |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1013975960 PECOS PAC ID: 0143449009 Enrollment ID: I20141201001937 |
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