| Kimberley Ann Houlihan Llc | |
|
30550 Gordy Mill Rd Delmar MD 21875-2043 | |
| (410) 430-9580 | |
| Not Available |
| Full Name | Kimberley Ann Houlihan Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 30550 Gordy Mill Rd, Delmar, Maryland |
| Authorized Official Name and Position | Kimberley Ann Houlihan (MEMBER) |
| Authorized Official Contact | 4104309580 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kimberley Ann Houlihan Llc 30339 Foskey Ln Delmar MD 21875-2000 Ph: (410) 430-9580 | Kimberley Ann Houlihan Llc 30550 Gordy Mill Rd Delmar MD 21875-2043 Ph: (410) 430-9580 |
| NPI Number | 1316576499 |
|---|---|
| Provider Enumeration Date | 04/02/2020 |
| Last Update Date | 04/02/2020 |
| Certification Date | 04/02/2020 |
| Medicare PECOS PAC ID | 4880025451 |
|---|---|
| Medicare Enrollment ID | O20200514002060 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316576499 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Kimberley Ann Houlihan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790222537 PECOS PAC ID: 5799116364 Enrollment ID: I20200514002244 |
Delmarva Counseling Center Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 28 E State St, Delmar, MD 21875 Phone: 410-896-3995 Fax: 410-896-2825 |