Cyndy Bourke, APRN/PMH

Individual provider Active NPI Mental Health Counselor · Centreville, MD

NPI 1477855658 · NPPES record last updated Nov 22, 2010

Key facts

NPI
1477855658
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
License
MD#R175635 (MD)
Practice address
114 W Water St Ste a
Centreville, MD 21617-1060
Phone
(410) 758-3008
Fax
(410) 758-3008
NPI assigned
Nov 22, 2010
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
MD#R175635MDMDMental Health Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MD#R175635 MD Yes

Addresses

Primary practice location

114 W Water St Ste a
Centreville, MD 21617-1060

Mailing address

114A West Water Street
Centreville, MD 21617
Phone (410) 758-3008

Other providers in Centreville, MD

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

Sources for this page

Verify at the official NPI Registry.