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General NPI Number Information
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NPI Number | 1124634241
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Entity Type | Organization
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Legal Business Name | RESPIRE BEHAVIORAL HEALTH
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Dates
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Enumeration Date | 09/23/2020
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Last Update Date | 10/12/2020
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Provider Practice Location Address
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Address Line | 479 JUMPERS HOLE RD STE 306
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City | SEVERNA PARK
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State | MD
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Zip | 21146-1751
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Country | US
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Telephone | 410-987-1036
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Fax |
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Provider Business Mailing Address
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Address Line | 112 W PENNSYLVANIA AVE STE 100
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City | BEL AIR
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State | MD
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Zip | 21014-3663
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Country | US
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Telephone | 410-987-1036
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Fax | 888-224-0984
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Authorized Official
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Title or Position | CHIEF CLINICAL OFFICER
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Name | DR. SYRETTA R JAMES
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Credential | PHD, ABPP
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Telephone | 410-987-1036
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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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 | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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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 | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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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 | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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