Healthcare Provider Details

I. General information

NPI: 1932885266
Provider Name (Legal Business Name): CLINICAL SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2023
Last Update Date: 06/22/2023
Certification Date: 06/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 BLACKBURN LN STE 150
BURTONSVILLE MD
20866-6127
US

IV. Provider business mailing address

4000 BLACKBURN LN STE 150
BURTONSVILLE MD
20866-6127
US

V. Phone/Fax

Practice location:
  • Phone: 301-421-4241
  • Fax: 410-696-3696
Mailing address:
  • Phone: 301-421-4241
  • Fax: 410-696-3696

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code163WP0807X
TaxonomyChild & Adolescent Psychiatric/Mental Health Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: LUIS MIGUEL ARGUETA
Title or Position: HR SPECIALIST
Credential:
Phone: 301-421-4241