Healthcare Provider Details

I. General information

NPI: 1245152271
Provider Name (Legal Business Name): BEHAVIORAL HEALTH OUTREACH MD, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2026
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3032 BRIGHTON ST
BALTIMORE MD
21216-3911
US

IV. Provider business mailing address

3032 BRIGHTON ST
BALTIMORE MD
21216-3911
US

V. Phone/Fax

Practice location:
  • Phone: 443-939-1001
  • Fax:
Mailing address:
  • Phone: 443-939-1001
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MR. DANTE HAROLD ALEXANDER
Title or Position: CEO
Credential:
Phone: 443-939-1001