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General NPI Number Information
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NPI Number | 1194016980
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Entity Type | Organization
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Legal Business Name | BEHAVIORAL INTERFACE
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Dates
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Enumeration Date | 04/27/2011
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Last Update Date | 01/25/2013
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Provider Practice Location Address
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Address Line | 3000 DRUID PARK DR SUITE 2A
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City | BALTIMORE
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State | MD
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Zip | 21215-7848
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Country | US
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Telephone | 410-664-0999
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Fax | 410-664-0699
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Provider Business Mailing Address
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Address Line | 3000 DRUID PARK DR SUITE 2A
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City | BALTIMORE
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State | MD
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Zip | 21215-7848
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Country | US
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Telephone | 410-664-0999
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Fax | 410-664-0699
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Authorized Official
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Title or Position | PRESIDENT/ THERAPIST
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Name | MS. MARGARET ANN BROWN
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Credential | LCSW-C
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Telephone | 410-664-0999
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 11901
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License Number State | MD
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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 | 049197
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 11901
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License Number State | MD
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