Healthcare Provider Details

I. General information

NPI: 1366019192
Provider Name (Legal Business Name): GIOVANNA AMA BAISIE-ARTHUR M.S, NCC, LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2021
Last Update Date: 05/13/2023
Certification Date: 05/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

632 FREDERICK RD STE 200
CATONSVILLE MD
21228-4696
US

IV. Provider business mailing address

632 FREDERICK RD STE 200
CATONSVILLE MD
21228-4696
US

V. Phone/Fax

Practice location:
  • Phone: 410-736-8010
  • Fax: 443-498-9697
Mailing address:
  • Phone: 443-470-9305
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLC13826
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLGP11553
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: