Healthcare Provider Details

I. General information

NPI: 1740194406
Provider Name (Legal Business Name): HARFORD BEHAVIORAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

216 N HICKORY AVE STE B
BEL AIR MD
21014-3242
US

IV. Provider business mailing address

311 LOGANWOOD CT
JOPPA MD
21085-3016
US

V. Phone/Fax

Practice location:
  • Phone: 443-617-9997
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number StateNULL

VIII. Authorized Official

Name: GALAXY GILL
Title or Position: OWNER
Credential: PMHNP-BC
Phone: 443-617-9997