Healthcare Provider Details

I. General information

NPI: 1639089568
Provider Name (Legal Business Name): COLLABORATING PSYCHIATRIST LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 SULGRAVE AVE STE 312A
BALTIMORE MD
21209-3654
US

IV. Provider business mailing address

1501 SULGRAVE AVE STE 312A
BALTIMORE MD
21209-3654
US

V. Phone/Fax

Practice location:
  • Phone: 410-205-1591
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: JOSEPH THOMAS ANDREWS
Title or Position: PRESIDENT
Credential: MD
Phone: 410-205-1591