=====================================================
General NPI Number Information
=====================================================
NPI Number | 1104537356
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SAP SOLUTIONS LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/08/2022
-----------------------------------------------------
Last Update Date | 12/08/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1900 E. NORTHERN PARKWAY SUITE T7
-----------------------------------------------------
City | BALTIMORE
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21239
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 443-744-3164
-----------------------------------------------------
Fax | 443-449-7583
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1900 E. NORTHERN PARKWAY SUITE T7
-----------------------------------------------------
City | BALTIMORE
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21239
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 443-744-3164
-----------------------------------------------------
Fax | 443-449-7583
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO/CLINICIAN
-----------------------------------------------------
Name | GARY L. HARDY
-----------------------------------------------------
Credential | LMSW
-----------------------------------------------------
Telephone | 443-744-3164
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 104100000X
-----------------------------------------------------
Taxonomy Name | Social Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------