Healthcare Provider Details

I. General information

NPI: 1992712897
Provider Name (Legal Business Name): UNIVERSITY OF MARYLAND PSYCHIATRY ASSOCIATES PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/02/2006
Last Update Date: 10/09/2025
Certification Date: 10/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 W PRATT ST FL 4
BALTIMORE MD
21201-1023
US

IV. Provider business mailing address

PO BOX 64515
BALTIMORE MD
21264-4515
US

V. Phone/Fax

Practice location:
  • Phone: 410-328-2539
  • Fax: 410-328-3522
Mailing address:
  • Phone: 717-428-0552
  • Fax: 717-428-0518

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier401609200
Identifier TypeMEDICAID
Identifier StateMD
Identifier Issuer

VIII. Authorized Official

Name: JILL RACHBEISEL
Title or Position: CHAIR
Credential: MD
Phone: 410-328-6771