Maryland Psychological and Management Services Center, LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

License

04983 Issued in MD

Legal business name

MARYLAND PSYCHOLOGICAL AND MANAGEMENT SERVICES CENTER, LLC

Practice address

10 W Madison St # 11
Baltimore, MD 21201-5239

Phone

(443) 438-7863

Fax

(443) 957-9485

NPI assigned

Jan 24, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Durwood Whitten, PHD

Title

Sole Proprietor

Phone

(443) 438-7863

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1358985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358985600000",
    "number": "1891033916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 W MADISON ST # 11",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212015239",
            "telephone_number": "443-438-7863",
            "fax_number": "443-957-9485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 W MADISON ST # 11",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212015239",
            "telephone_number": "443-438-7863",
            "fax_number": "443-957-9485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYLAND PSYCHOLOGICAL AND MANAGEMENT SERVICES CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-24",
        "last_updated": "2013-01-24",
        "status": "A",
        "authorized_official_last_name": "WHITTEN",
        "authorized_official_first_name": "DURWOOD",
        "authorized_official_title_or_position": "SOLE PROPRIETOR",
        "authorized_official_telephone_number": "443-438-7863",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "MD",
            "license": "04983",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "052304600",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Maryland Provo-I Medical Services, PC
• Maryland Psychiatric Associates LLC
• Maryland Psychiatric Care
• Maryland Psychotherapy Services LLC
• Maryland Recovery Homes LLC
• Maryland Recovery Organization Connecting Communities (M-Rocc)
• Maryland Rehab Specialists
• Maryland Spine Center Chartered

• Mental Health Clinic/Center (Including Community Mental Health Center) in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2013; 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.