Healthcare Provider Details

I. General information

NPI: 1619889912
Provider Name (Legal Business Name): BMORE PSYCHOTHERAPY GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2331 YORK RD STE 200
TIMONIUM MD
21093-2249
US

IV. Provider business mailing address

2331 YORK RD STE 200
TIMONIUM MD
21093-2249
US

V. Phone/Fax

Practice location:
  • Phone: 410-834-5380
  • Fax: 410-834-5380
Mailing address:
  • Phone: 410-834-5380
  • Fax: 410-834-5380

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: CASEY MILES BENNETT
Title or Position: COUNSELOR/OWNER
Credential: LCPC, LPC
Phone: 410-834-5380