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General NPI Number Information
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NPI Number | 1023987633
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Entity Type | Organization
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Legal Business Name | FREDERICK BEHAVIORAL HEALTH SERVICES, LLC
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Dates
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Enumeration Date | 11/03/2025
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Last Update Date | 11/03/2025
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Provider Practice Location Address
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Address Line | 9861 BROKEN LAND PKWY STE 100
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City | COLUMBIA
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State | MD
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Zip | 21046-3031
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Country | US
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Telephone | 301-321-8245
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Fax | 301-238-7915
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Provider Business Mailing Address
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Address Line | 5100 BUCKEYSTOWN PIKE STE 250
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City | FREDERICK
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State | MD
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Zip | 21704-8344
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Country | US
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Telephone | 301-321-8245
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Fax | 301-238-7915
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Authorized Official
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Title or Position | CEO
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Name | THOMAS COLLIGAN
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Credential |
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Telephone | 301-321-8245
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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