| Walden Behavioral | |
|
85 High St Suite 4 Waldorf MD 20602-2150 | |
| (301) 997-1300 | |
| (301) 863-4744 |
| Full Name | Walden Behavioral |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 85 High St, Waldorf, Maryland |
| Authorized Official Name and Position | Jason Hendricks (CEO) |
| Authorized Official Contact | 8149400407 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Walden Behavioral 30007 Business Center Dr Charlotte Hall MD 20622-3101 Ph: (301) 997-1300 | Walden Behavioral 85 High St Suite 4 Waldorf MD 20602-2150 Ph: (301) 997-1300 |
| NPI Number | 1053611616 |
|---|---|
| Provider Enumeration Date | 10/29/2010 |
| Last Update Date | 04/10/2024 |
| Certification Date | 04/10/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053611616 | NPI | - | NPPES |
| 7800355-00 | Medicaid | MD | |
| 7451881-02 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
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