Angela Bates

Individual provider Active NPI Mental Health Counselor · Brandywine, MD

NPI 1457028110 · NPPES record last updated Aug 31, 2023

Key facts

NPI
1457028110
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
Practice address
11600 Cedarville Rd
Brandywine, MD 20613-7968
Phone
(301) 262-2270
NPI assigned
Aug 30, 2021
Sex
Female
Sole proprietor
Yes

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare Care Compare profile

Specialty
Mental Health Counselor
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Safe Harbor Behavioral Care LLC (81 clinicians)

Practice addresses (Care Compare)

5054 Dorsey Hall Dr
Suite 105
Ellicott City, MD 21042-7795
Phone (410) 893-4600

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20240524000178 MD Practitioner - Mental Health Counselor 1456795913 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Genesis Counseling Service, Inc. Mental Health Current
since Sep 24, 2023
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LC14278 MD
Mental Health Counselor 101YM0800X Yes

Addresses

Primary practice location

11600 Cedarville Rd
Brandywine, MD 20613-7968

Mailing address

10808 Phillips Dr
Upper Marlboro, MD 20772-4624
Phone (301) 704-1445

Other practice location 1

5869 Allentown Rd
Camp Springs, MD 20746-4548
Phone (301) 433-8777

Other providers in Brandywine, MD

All providers in Brandywine, MD · Mental Health Counselor in Maryland

Sources for this page

Verify at the official NPI Registry.