Healthcare Provider Details

I. General information

NPI: 1992669758
Provider Name (Legal Business Name): CAMISHAK MAJOR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1099 WINTERSON RD STE 250B
LINTHICUM HEIGHTS MD
21090-2223
US

IV. Provider business mailing address

1099 WINTERSON RD STE 250B
LINTHICUM HEIGHTS MD
21090-2223
US

V. Phone/Fax

Practice location:
  • Phone: 240-294-8399
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: