Bayside Therapy, PC

Organization Active NPI Professional Counselor · North Beach, MD

NPI 1124282371 · NPPES record last updated Sep 21, 2023

Key facts

NPI
1124282371
Entity type
Organization (NPI type 2)
Primary specialty
Professional Counselor 101YP2500X
License
2600 (MD)
Legal business name
BAYSIDE THERAPY, PC
Practice address
8835 Chesapeake Avenue
North Beach, MD 20714
Phone
(301) 399-4696
Fax
(410) 741-3047
NPI assigned
Jul 17, 2008
Organization subpart
No

Authorized official

Name
Dr. Martha Kimberly Kesler, PH.D., LCPC
Title
Ceo
Phone
(301) 399-4696

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MD

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20240523000235 MD Part B Supplier - Clinic/Group Practice 0143662007 Receives reassigned benefits from 1 practitioner
Practice locations: North Beach, MD

National Provider Directory

Locations

8835 Chesapeake Ave
North Beach, MD 20714
Phone (301) 399-4696

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor
Group: 193400000X SINGLE SPECIALTY GROUP
101YP2500X 2600 MD Yes

Addresses

Primary practice location

8835 Chesapeake Avenue
North Beach, MD 20714

Mailing address

PO Box 762
North Beach, MD 20714-0762
Phone (301) 399-4696

Other providers in North Beach, MD

All providers in North Beach, MD · Professional Counselor in Maryland

Sources for this page

Verify at the official NPI Registry.