Healthcare Provider Details

I. General information

NPI: 1063354686
Provider Name (Legal Business Name): MARGARET BLEVINS ADT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/06/2026
Last Update Date: 04/06/2026
Certification Date: 04/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5710 RITCHIE HWY
BROOKLYN PARK MD
21225-3641
US

IV. Provider business mailing address

4602 WATERFALL CT APT H
OWINGS MILLS MD
21117-7606
US

V. Phone/Fax

Practice location:
  • Phone: 410-636-5600
  • Fax: 410-636-5600
Mailing address:
  • Phone: 443-957-5799
  • Fax: 410-636-5600

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberADT3604
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: