| Sheppard Pratt Health System, Inc. | |
|
2940 Point Of Rocks Road Jefferson MD 21755-0009 | |
| (301) 629-8400 | |
| (301) 629-8404 |
| Full Name | Sheppard Pratt Health System, Inc. |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 2940 Point Of Rocks Road, Jefferson, Maryland |
| Authorized Official Name and Position | Bonnie B. Katz (VP CORPORATE BUSINESS DEVELOPMENT) |
| Authorized Official Contact | 4109383150 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sheppard Pratt Health System, Inc. 6501 North Charles Street Baltimore MD 21204-6819 Ph: (410) 938-3000 | Sheppard Pratt Health System, Inc. 2940 Point Of Rocks Road Jefferson MD 21755-0009 Ph: (301) 629-8400 |
| NPI Number | 1518011659 |
|---|---|
| Provider Enumeration Date | 01/23/2007 |
| Last Update Date | 01/16/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518011659 | NPI | - | NPPES |
| 201901900 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | 3801 (Maryland) | Primary |
Breakthrough Counseling Services, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4014j Mountville Rd Unit A, Jefferson, MD 21755 Phone: 240-215-6434 | |
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