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General NPI Number Information
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NPI Number | 1528962636
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Entity Type | Organization
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Legal Business Name | THE ROSEDALE BAPTIST CHURCH OF BALTIMORE
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Dates
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Enumeration Date | 10/05/2026
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Last Update Date | 10/05/2026
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Provider Practice Location Address
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Address Line | 9202 PHILADELPHIA RD
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City | BALTIMORE
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State | MD
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Zip | 21237-4319
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Country | US
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Telephone | 410-682-4114
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Fax |
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Provider Business Mailing Address
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Address Line | 9202 PHILADELPHIA RD
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City | BALTIMORE
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State | MD
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Zip | 21237-4319
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Country | US
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Telephone | 410-682-4114
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Fax |
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Authorized Official
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Title or Position | COUNSELING CENTER DIRECTOR
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Name | DR. XAVIE J SMALL
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Credential | PHD, LCPC
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Telephone | 667-378-9001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 | NULL
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