Healthcare Provider Details

I. General information

NPI: 1699097378
Provider Name (Legal Business Name): COMMITTED TO CHANGE, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2010
Last Update Date: 04/18/2026
Certification Date: 04/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 GLENN ST STE 302
CUMBERLAND MD
21502-2583
US

IV. Provider business mailing address

200 GLENN ST STE 302
CUMBERLAND MD
21502-2583
US

V. Phone/Fax

Practice location:
  • Phone: 240-580-1919
  • Fax: 240-362-7409
Mailing address:
  • Phone: 240-580-1919
  • Fax: 240-362-7409

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberD0058483
License Number StateMD

VIII. Authorized Official

Name: DR. RAJENDRA LOWTAN
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 240-580-1919