Community Behavioral Health, LLC
Organization Active NPI Community/Behavioral Health Agency · Columbia, MD
NPI 1730626201 · NPPES record last updated Sep 28, 2021
Key facts
- NPI
- 1730626201
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Behavioral Health Agency 251S00000X
- Legal business name
- COMMUNITY BEHAVIORAL HEALTH, LLC
- Practice address
- 10810 Hickory Ridge Rd
Columbia, MD 21044-3622 - Phone
- (844) 224-5264
- Fax
- (888) 509-0010
- NPI assigned
- Jan 23, 2017
- Organization subpart
- No
Authorized official
- Name
- Ms. Lacy Gilbert
- Title
- Director of Operations
- Phone
- (844) 224-5264
Other NPIs on the same Medicare enrollment 13
Corporate family (same tax ID) 24
Practitioners 1
-
Patti R Dudley, LCSW-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MD
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20140429000721 | MD | Part B Supplier - Clinic/Group Practice | 2567693849 |
Receives reassigned benefits from 8 practitioners 13 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Salisbury, MD; Snow Hill, MD; Princess Anne, MD; Easton, MD; Columbia, MD; Chestertown, MD; Centreville, MD; Cambridge, MD |
National Provider Directory
- Tax ID family
- Comm Behav HLTH LLC
Locations
10810 Hickory Ridge Rd
Columbia, MD 21044
Phone (410) 997-5500
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | Yes |
Addresses
Primary practice location
10810 Hickory Ridge Rd
Columbia, MD 21044-3622
Mailing address
821 Eastern Shore Dr
Salisbury, MD 21804-5943
Phone (844) 224-5264
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4226127 | Medicaid | MD |
Other providers in Columbia, MD
- Community Behavioral Health, LLC
- Community Behavioral Health, LLC
- Community Behavioral Health, LLC
- Community Behavioral Health, LLC
- Community Behavioral Health, LLC
- Community Counseling Assoc
- Community Neurology Health LLC
- Pamela Jane Compart
- Compass Mental Health Consultants, LLC
- Compassionate Multi Health Group Inc
All providers in Columbia, MD · Community/Behavioral Health Agency in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 28, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.