Healthcare Provider Details

I. General information

NPI: 1669392254
Provider Name (Legal Business Name): AGAPE COUNSELING AND RECOVERY SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2710 POPLAR DR
BALTIMORE MD
21207-6088
US

IV. Provider business mailing address

2710 POPLAR DR
BALTIMORE MD
21207-6088
US

V. Phone/Fax

Practice location:
  • Phone: 443-794-3439
  • Fax:
Mailing address:
  • Phone: 443-794-3439
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name: BERNARD ROBERSON
Title or Position: OWNER
Credential: LCADC
Phone: 443-794-3439