Healthcare Provider Details

I. General information

NPI: 1689537417
Provider Name (Legal Business Name): PEACE AND PROGRESS BEHAVIORAL HEALTH SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2025
Last Update Date: 12/08/2025
Certification Date: 11/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1343 STONEWOOD RD.
BALTIMORE MD
21239
US

IV. Provider business mailing address

5835 YORK RD # 1124
BALTIMORE MD
21212-3612
US

V. Phone/Fax

Practice location:
  • Phone: 910-939-1003
  • Fax:
Mailing address:
  • Phone: 910-939-1003
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MRS. DANIELLE JONES-HIGGINBOTTOM
Title or Position: OWNER/OPERATOR
Credential: LCSW
Phone: 910-939-1003