Healthcare Provider Details

I. General information

NPI: 1447826771
Provider Name (Legal Business Name): BUILDING PEOPLE BEHAVIORAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2021
Last Update Date: 01/10/2022
Certification Date: 01/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2140 MCCULLOH ST
BALTIMORE MD
21217-3529
US

IV. Provider business mailing address

2140 MCCULLOH ST
BALTIMORE MD
21217-3529
US

V. Phone/Fax

Practice location:
  • Phone: 443-802-0284
  • Fax:
Mailing address:
  • Phone: 104-864-2973
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code163WA0400X
TaxonomyAddiction (Substance Use Disorder) Registered Nurse
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. SCOTTEANA VICTORIA CARTER
Title or Position: PROGRAM DIRECTOR
Credential: MBA
Phone: 410-864-2973