Healthcare Provider Details

I. General information

NPI: 1184909780
Provider Name (Legal Business Name): CONSULTATION & CRISIS INTERVENTION ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2011
Last Update Date: 10/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6565 N CHARLES ST PPE# 211
BALTIMORE MD
21204-6800
US

IV. Provider business mailing address

6565 N CHARLES ST PPE# 211
BALTIMORE MD
21204-6800
US

V. Phone/Fax

Practice location:
  • Phone: 443-849-2369
  • Fax: 443-849-2248
Mailing address:
  • Phone: 443-849-2369
  • Fax: 443-849-2248

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number04153
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number04668
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number04535
License Number StateMD
# 4
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberH0059634
License Number StateMD
# 5
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberD0036535
License Number StateMD
# 6
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberD0063687
License Number StateMD
# 7
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberD0069596
License Number StateMD
# 8
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberD0072416
License Number StateMD
# 9
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberH0072194
License Number StateMD
# 10
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberD0065120
License Number StateMD
# 11
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberD0059449
License Number StateMD

VIII. Authorized Official

Name: DR. RAHSAAN LATEEF LINDSEY
Title or Position: PHYSICIAN
Credential: MD
Phone: 443-849-2369