Healthcare Provider Details

I. General information

NPI: 1922156009
Provider Name (Legal Business Name): THOMAS T. TRUSS, PHD, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 03/24/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 S PRESIDENT ST SUITE 403
BALTIMORE MD
21202-4462
US

IV. Provider business mailing address

924 E BALTIMORE ST
BALTIMORE MD
21202-4736
US

V. Phone/Fax

Practice location:
  • Phone: 410-342-7221
  • Fax: 410-244-1414
Mailing address:
  • Phone: 410-342-7221
  • Fax: 410-244-1414

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number01592
License Number StateMD

VIII. Authorized Official

Name: DR. THOMAS T. TRUSS
Title or Position: PRESIDENT
Credential: PHD
Phone: 410-342-7221