Healthcare Provider Details

I. General information

NPI: 1912500463
Provider Name (Legal Business Name): SENIOR CARE THERAPY LCSW OF MARYLAND LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/18/2020
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

822 GUILFORD AVE # 1526
BALTIMORE MD
21202-3707
US

IV. Provider business mailing address

575 STATE ROUTE 28 BUILDING TWO, STE 2108
RARITAN NJ
08869
US

V. Phone/Fax

Practice location:
  • Phone: 973-264-0023
  • Fax: 973-264-0022
Mailing address:
  • Phone: 973-264-0023
  • Fax: 973-264-0022

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: MATTHEW BARNAS
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: MD
Phone: 973-264-0023