Healthcare Provider Details

I. General information

NPI: 1801328273
Provider Name (Legal Business Name): BRIGHT HORIZONS BEHAVIORAL HEALTH INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2017
Last Update Date: 05/03/2024
Certification Date: 05/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3531 WASHINGTON BLVD STE 220-224
HALETHORPE MD
21227-1603
US

IV. Provider business mailing address

3531 WASHINGTON BLVD STE 220-240
HALETHORPE MD
21227-1603
US

V. Phone/Fax

Practice location:
  • Phone: 410-204-8971
  • Fax: 888-760-4333
Mailing address:
  • Phone: 571-288-3314
  • Fax: 888-760-4333

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MRS. SANDRA COOPER
Title or Position: PRESIDENT
Credential:
Phone: 571-288-3314