Organization Active NPI

University Psychological Center, Inc

  • Substance Abuse Rehabilitation Facility
  • Baltimore, MD
National Provider Identifier
1245767433
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
906321 Issued in MD
Legal business name
UNIVERSITY PSYCHOLOGICAL CENTER, INC
Practice address
824 N Broadway
Baltimore, MD 21205-1425
Phone
(410) 576-9191
Fax
(410) 576-9257
NPI assigned
May 18, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Dr. Clark J Hudak Jr., PH.D.
Title
Ceo
Phone
(410) 576-9191

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 906321 MD Primary

Addresses

Primary practice location

824 N Broadway
Baltimore, MD 21205-1425

Mailing address

814 N Broadway
Baltimore, MD 21205-1425
Phone (410) 576-9191

Other names 1

  • Recovery Ntwork Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Univ Psychological Ctr Inc32 organizations share this tax ID, including this one

Other organizations with this tax ID 31

Organizations that report the same tax identification number in the National Provider Directory.

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1495065600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1245767433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "814 N BROADWAY",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212051425",
            "telephone_number": "410-576-9191",
            "fax_number": "410-576-9257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "824 N BROADWAY",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212051425",
            "telephone_number": "410-576-9191",
            "fax_number": "410-576-9257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY PSYCHOLOGICAL CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-18",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "HUDAK",
        "authorized_official_first_name": "CLARK",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "410-576-9191",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "MD",
            "license": "906321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Recovery Ntwork",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.