| Green Door Family Psychiatry Llc | |
|
604 Moores Mill Rd Ste B Bel Air MD 21014-2726 | |
| (410) 652-6701 | |
| Not Available |
| Full Name | Green Door Family Psychiatry Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 604 Moores Mill Rd Ste B, Bel Air, 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 1622 Harkins Rd Pylesville MD 21132-1623 Ph: (410) 652-6701 | Green Door Family Psychiatry Llc 604 Moores Mill Rd Ste B Bel Air MD 21014-2726 Ph: (410) 652-6701 |
| NPI Number | 1598582850 |
|---|---|
| Provider Enumeration Date | 09/26/2024 |
| Last Update Date | 09/26/2024 |
| Certification Date | 09/26/2024 |
| Medicare PECOS PAC ID | 9436683463 |
|---|---|
| Medicare Enrollment ID | O20241113000470 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598582850 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| 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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