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General NPI Number Information
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NPI Number | 1043417330
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Entity Type | Organization
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Legal Business Name | SAMUEL BERKOWITZ, PH.D., INC.
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Dates
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Enumeration Date | 06/29/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 5018 DORSEY HALL DR SUITE 205
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City | ELLICOTT CITY
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State | MD
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Zip | 21042-7855
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Country | US
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Telephone | 410-730-5138
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Fax | 410-997-0603
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Provider Business Mailing Address
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Address Line | 5018 DORSEY HALL DR SUITE 205
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City | ELLICOTT CITY
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State | MD
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Zip | 21042-7855
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Country | US
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Telephone | 410-730-5138
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Fax | 410-997-0603
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Authorized Official
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Title or Position | PSYCHOLOGIST OWNER
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Name | SAMUEL BERKOWITZ
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Credential | PH.D.
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Telephone | 410-730-5138
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 461-MD
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License Number State | MD
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