Healthcare Provider Details

I. General information

NPI: 1649747569
Provider Name (Legal Business Name): BARBARA ELGIN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/29/2018
Last Update Date: 10/26/2023
Certification Date: 10/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 PAWLEYS CT
NOTTINGHAM MD
21236-3235
US

IV. Provider business mailing address

6 PAWLEYS CT
NOTTINGHAM MD
21236-3235
US

V. Phone/Fax

Practice location:
  • Phone: 410-967-3848
  • Fax:
Mailing address:
  • Phone: 410-967-3848
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: BARBARA ELGIN
Title or Position: FOUNDER/OWNER
Credential: MSW, LCSW-C
Phone: 410-967-3848