Healthcare Provider Details

I. General information

NPI: 1114498300
Provider Name (Legal Business Name): WAY STATION, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2018
Last Update Date: 08/06/2025
Certification Date: 08/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

228 W PATRICK ST
FREDERICK MD
21701-6946
US

IV. Provider business mailing address

PO BOX 791888
BALTIMORE MD
21279-1888
US

V. Phone/Fax

Practice location:
  • Phone: 301-662-0099
  • Fax: 301-695-2716
Mailing address:
  • Phone: 240-608-3464
  • Fax: 301-695-2716

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name: SUE KESSLER
Title or Position: DIRECTOR, REVENUE CYCLE
Credential:
Phone: 410-382-8111