Healthcare Provider Details

I. General information

NPI: 1700435914
Provider Name (Legal Business Name): NEW INSIGHTS BEHAVIORAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2019
Last Update Date: 10/20/2020
Certification Date: 10/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2718 WEST NORTH AVE SUITE 255
BALTIMORE MD
21216-3138
US

IV. Provider business mailing address

2718 WEST NORTH AVE SUITE 255
BALTIMORE MD
21216-3138
US

V. Phone/Fax

Practice location:
  • Phone: 410-919-8618
  • Fax:
Mailing address:
  • Phone: 410-919-8618
  • 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 Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. KAREN L TERRY
Title or Position: PROGRAM DIRECTOR
Credential:
Phone: 410-449-5129