Deep Blue Clinical Services, PLLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

DEEP BLUE CLINICAL SERVICES, PLLC

Practice address

30 E Padonia Rd Ste 202
Timonium, MD 21093-2308

Phone

(443) 377-1507

NPI assigned

Mar 22, 2023

Last updated

Mar 22, 2023By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Daniel Blumenthal

Title

Psychotherapist

Phone

(443) 377-1507

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1679443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679443200000",
    "number": "1184327017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 PAULINE DR # 1087",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174024637",
            "telephone_number": "443-377-1507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 E PADONIA RD STE 202",
            "city": "TIMONIUM",
            "state": "MD",
            "postal_code": "210932308",
            "telephone_number": "443-377-1507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEEP BLUE CLINICAL SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-22",
        "last_updated": "2023-03-22",
        "certification_date": "2023-03-22",
        "status": "A",
        "authorized_official_last_name": "BLUMENTHAL",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "443-377-1507"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Corey Molzon Davis, PSY.D.
• Gayle Helene Davis, MA, LCMFT
• DBT of Baltimore, LLC
• Lauren De Marco, LCSW-C
• Heginio De Vera, PT
• Julia Deibler, LCSW-C
• Carol Ann Dell'Uomo, LCSW-C
• Denise Donna Demback, L.AC.
• Dennis Gene Foster,Jr.,D.D.S.
• Lindsay M Dennison, AU.D.

• Community/Behavioral Health Agency in Timonium, MD
• Providers in Timonium, MD by specialty
• Community/Behavioral Health Agency in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.