Healthcare Provider Details

I. General information

NPI: 1922975358
Provider Name (Legal Business Name): COGNITIVE ELEVATIONS BEHAVIORAL HEALTH SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2025
Last Update Date: 10/21/2025
Certification Date: 10/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 W CHESAPEAKE AVE STE 605
TOWSON MD
21204-4891
US

IV. Provider business mailing address

40 W CHESAPEAKE AVE STE 605
TOWSON MD
21204-4891
US

V. Phone/Fax

Practice location:
  • Phone: 443-831-9800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DANIELLE BOYKIN
Title or Position: BILLER
Credential:
Phone: 443-677-5094