| Green Door Family Psychiatry Llc | |
|
4690 Millennium Dr Ste 348 Belcamp MD 21017-1523 | |
| (410) 652-6701 | |
| Not Available |
| Full Name | Green Door Family Psychiatry Llc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 4690 Millennium Dr Ste 348, Belcamp, Maryland |
| Authorized Official Name and Position | Michelle Shaneyfelt-jarzynski (OWNER) |
| Authorized Official Contact | 4106526701 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Green Door Family Psychiatry Llc 4690 Millennium Dr Ste 348 Belcamp MD 21017-1523 Ph: (410) 652-6701 | Green Door Family Psychiatry Llc 4690 Millennium Dr Ste 348 Belcamp MD 21017-1523 Ph: (410) 652-6701 |
| NPI Number | 1598582850 |
|---|---|
| Provider Enumeration Date | 09/26/2024 |
| Last Update Date | 09/02/2025 |
| Certification Date | 09/02/2025 |
| Medicare PECOS PAC ID | 9436683463 |
|---|---|
| Medicare Enrollment ID | O20241113000470 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598582850 | NPI | - | NPPES |
| Provider Name | Michelle Shaneyfelt-jarzynski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912631813 PECOS PAC ID: 0345692513 Enrollment ID: I20240124000109 |
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