Healthcare Provider Details

I. General information

NPI: 1568115616
Provider Name (Legal Business Name): DSTND4GR8NS BEHAVIORAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2022
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 W PENNSYLVANIA AVE STE 309A
TOWSON MD
21204-5009
US

IV. Provider business mailing address

22 W PENNSYLVANIA AVE STE 309A
TOWSON MD
21204-5009
US

V. Phone/Fax

Practice location:
  • Phone: 443-898-2620
  • Fax:
Mailing address:
  • Phone: 443-898-2620
  • 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 TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. RONALD E. SATTERFIELD JR.
Title or Position: CEO
Credential: LCADC, LMSW
Phone: 443-898-2620