| Sheppard Pratt Health System, Inc. | |
|
4915 Aspen Hill Rd Rockville MD 20853-3709 | |
| (301) 947-3761 | |
| Not Available |
| Full Name | Sheppard Pratt Health System, Inc. |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 4915 Aspen Hill Rd, Rockville, Maryland |
| Authorized Official Name and Position | Bonnie B. Katz (VP BUSINESS DEVEL AND SUPPORT OPS) |
| Authorized Official Contact | 4109383154 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sheppard Pratt Health System, Inc. 17051 Oakmont Ave Gaithersburg MD 20877-4142 Ph: (301) 947-3761 | Sheppard Pratt Health System, Inc. 4915 Aspen Hill Rd Rockville MD 20853-3709 Ph: (301) 947-3761 |
| NPI Number | 1558652370 |
|---|---|
| Provider Enumeration Date | 04/27/2011 |
| Last Update Date | 11/22/2021 |
| Certification Date | 11/22/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558652370 | NPI | - | NPPES |
| 523703300 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | 298 (Maryland) | Primary |
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