Healthcare Provider Details

I. General information

NPI: 1801794847
Provider Name (Legal Business Name): RESERVE PROFESSIONAL SERVICES GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/29/2026
Last Update Date: 11/02/2026
Certification Date: 11/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4030 GILL AVE
HAMPSTEAD MD
21074-2213
US

IV. Provider business mailing address

942 MAGNOLIA BLOSSOM CT
SYKESVILLE MD
21784-7688
US

V. Phone/Fax

Practice location:
  • Phone: 443-777-0925
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL GRIESSER
Title or Position: OWNER/CEO
Credential:
Phone: 443-890-4309