| Restorative Behavioral Health, Inc. | |
| 
					29 Broad St Ste 202a Berlin MD 21811-1054  | |
| (667) 288-1566 | |
| Not Available | 
| Full Name | Restorative Behavioral Health, Inc. | 
|---|---|
| Speciality | Nurse Practitioner | 
| Location | 29 Broad St Ste 202a, Berlin, Maryland | 
| Authorized Official Name and Position | Charleen Lauren Gonden (CEO) | 
| Authorized Official Contact | 6672881566 | 
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Restorative Behavioral Health, Inc. 29 Broad St Ste 202a Berlin MD 21811-1054 Ph: (667) 288-1566  | Restorative Behavioral Health, Inc. 29 Broad St Ste 202a Berlin MD 21811-1054 Ph: (667) 288-1566  | 
| NPI Number | 1720728561 | 
|---|---|
| Provider Enumeration Date | 03/30/2022 | 
| Last Update Date | 06/06/2025 | 
| Certification Date | 06/06/2025 | 
| Medicare PECOS PAC ID | 3375919376 | 
|---|---|
| Medicare Enrollment ID | O20221017000950 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1720728561 | NPI | - | NPPES | 
| 1255822565 | Other | PA | NPI NUMBER | 
| Provider Name | Charleen Lauren Gonden | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1255822565 PECOS PAC ID: 3072850890 Enrollment ID: I20221017001115  | 
| Provider Name | Rochelle Hall | 
|---|---|
| Provider Type | Practitioner - Clinical Social Worker | 
| Provider Identifiers | NPI Number: 1770804783 PECOS PAC ID: 8729254388 Enrollment ID: I20230827000023  | 
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