Healthcare Provider Details

I. General information

NPI: 1609752591
Provider Name (Legal Business Name): SUMMIT MARYLAND MEDICAL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2025
Last Update Date: 03/30/2026
Certification Date: 03/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1587 SULPHUR SPRING RD STE 109
BALTIMORE MD
21227-2552
US

IV. Provider business mailing address

1587 SULPHUR SPRING RD STE 109
BALTIMORE MD
21227-2552
US

V. Phone/Fax

Practice location:
  • Phone: 410-246-1508
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: CHRISTINA MEYER
Title or Position: DIRECTOR OF PROGRAMS
Credential: LMSW
Phone: 410-961-1866