MEDICARE: PYRAMID WALDEN LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1306128434
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PYRAMID WALDEN LLC

Provider Business Mailing Address
First Line	:	30007 BUSINESS CENTER DR
Second Line	:
City	:	CHARLOTTE HALL
State	:	MD
Zip	:	20622-3101
Country	:	US
Telephone Number	:	301-997-1300
Fax Number	:	301-863-4744

Provider Business Practice Location Address
First Line	:	85 HIGH ST
Second Line	:	SUITE 4
City	:	WALDORF
State	:	MD
Zip	:	20602-2150
Country	:	US
Telephone Number	:	888-912-7366
Fax Number	:	301-290-0280

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	JASON HENDRICKS
Credential	:
Telephone Number	:	814-940-0407

Provider Enumeration Date	:	09/14/2011
Last Update Date	:	04/10/2024

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Directions to “PYRAMID WALDEN LLC ” Practice Location

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