Healthcare Provider Details

I. General information

NPI: 1831007913
Provider Name (Legal Business Name): YUE PENG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2440 CYLBURN AVE 2ND FLOOR
BALTIMORE MD
21215
US

IV. Provider business mailing address

2440 CYLBURN AVE 2ND FLOOR
BALTIMORE MD
21215
US

V. Phone/Fax

Practice location:
  • Phone: 773-658-5886
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLGP18344
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: