Healthcare Provider Details

I. General information

NPI: 1801213889
Provider Name (Legal Business Name): MEDPSYCH HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2014
Last Update Date: 03/27/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7101 GUILFORD DR STE 100
FREDERICK MD
21704-5198
US

IV. Provider business mailing address

7101 GUILFORD DR STE 100
FREDERICK MD
21704-5198
US

V. Phone/Fax

Practice location:
  • Phone: 240-464-8000
  • Fax:
Mailing address:
  • Phone: 240-464-8000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: MANDEEP SINGH
Title or Position: COO
Credential:
Phone: 240-464-8000