Healthcare Provider Details

I. General information

NPI: 1992492961
Provider Name (Legal Business Name): LEADING BY EXAMPLE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2023
Last Update Date: 11/20/2023
Certification Date: 11/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3001 E BIDDLE ST
BALTIMORE MD
21213-3940
US

IV. Provider business mailing address

5026 CAMPBELL BLVD STE H
NOTTINGHAM MD
21236-5051
US

V. Phone/Fax

Practice location:
  • Phone: 443-438-7614
  • Fax: 443-835-4776
Mailing address:
  • Phone: 410-780-2692
  • Fax: 410-780-2694

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MARY RIMI
Title or Position: OUTPATIENT MENTAL HEALTH DIRECTOR
Credential: LCPC
Phone: 443-889-9544