Michael Allen

Individual provider Active NPI Mental Health Clinic/Center (Including Community Mental Health Center) · Ellicott City, MD

NPI 1821638271 · NPPES record last updated Jan 14, 2020

Key facts

NPI
1821638271
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Practice address
2850 N Ridge Rd Ste 210
Ellicott City, MD 21043-3463
Phone
(410) 961-8423
NPI assigned
Jan 14, 2020
Sex
Male
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
BH001887MDMDMental Health Clinic/Center (Including Community Mental Health Center)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X BH001887 MD
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Yes

Addresses

Primary practice location

2850 N Ridge Rd Ste 210
Ellicott City, MD 21043-3463

Mailing address

2850 N Ridge Rd Ste 210
Ellicott City, MD 21043-3463

Other providers in Ellicott City, MD

All providers in Ellicott City, MD · Mental Health Clinic/Center (Including Community Mental Health Center) in Maryland

Sources for this page

Verify at the official NPI Registry.