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NPI Code Detail

MEDICARE: ADVANCED BEHAVIORAL HEALTH, INC.

MEDICARE: ADVANCED BEHAVIORAL HEALTH, INC.
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
12084P0804XChild & Adolescent Psychiatry Physician

General Provider Information

NPI Number : 1538455381
Entity Type Code : Organization
Provider Name (Legal Business Name) : ADVANCED BEHAVIORAL HEALTH, INC.
Provider Business Mailing Address
First Line : 1003 W 7TH ST STE 500
Second Line :
City : FREDERICK
State : MD
Zip : 21701-8512
Country : US
Telephone Number : 301-345-1022
Fax Number : 301-682-2472
Provider Business Practice Location Address
First Line : 7474 GREENWAY CENTER DR STE 730
Second Line :
City : GREENBELT
State : MD
Zip : 20770-3523
Country : US
Telephone Number : 301-345-1022
Fax Number : 301-682-2472
Authorized Official
Title or Position : CEO/ PROGRAM DIRECTOR
Name : VERA KURDIAN
Credential : MSW, LCSW-C
Telephone Number : 301-345-1022
Provider Enumeration Date : 06/21/2011
Last Update Date : 07/15/2020

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