Healthcare Provider Details

I. General information

NPI: 1417865239
Provider Name (Legal Business Name): HORACE ANDREW GREELEY
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

221 MAITLAND ST STE 204
BEL AIR MD
21014-3930
US

IV. Provider business mailing address

221 MAITLAND ST
BEL AIR MD
21014-3939
US

V. Phone/Fax

Practice location:
  • Phone: 443-787-4482
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLGP18307
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: