Healthcare Provider Details

I. General information

NPI: 1053101261
Provider Name (Legal Business Name): KAMILI BEHAVIORAL HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2025
Last Update Date: 11/20/2025
Certification Date: 11/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2119 N CHARLES ST STE 14&15
BALTIMORE MD
21218-5779
US

IV. Provider business mailing address

2902 E FEDERAL ST
BALTIMORE MD
21213-3910
US

V. Phone/Fax

Practice location:
  • Phone: 667-228-2074
  • Fax:
Mailing address:
  • Phone: 667-228-2074
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MARLENE WILLIAMS
Title or Position: PRESIDENT/CEO
Credential: LCSW-C
Phone: 443-253-0174