=====================================================
General NPI Number Information
=====================================================
NPI Number | 1437626900
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | THE BEHAVIOR SAVIOR LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/01/2018
-----------------------------------------------------
Last Update Date | 07/18/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1829 REISTERSTOWN RD STE 350
-----------------------------------------------------
City | PIKESVILLE
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21208-7126
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 410-449-7660
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3318 KEYSER RD
-----------------------------------------------------
City | PIKESVILLE
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21208-1914
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 410-615-4201
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MR. ADAM MARC LEBOWITZ
-----------------------------------------------------
Credential | LCSW-C
-----------------------------------------------------
Telephone | 410-615-4201
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------