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General NPI Number Information
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NPI Number | 1700538717
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Entity Type | Organization
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Legal Business Name | CONNECTED CARE BEHAVIORAL HEALTH LLC
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Dates
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Enumeration Date | 01/20/2022
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Last Update Date | 01/20/2022
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Provider Practice Location Address
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Address Line | 9199 REISTERSTOWN RD STE 202B
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City | OWINGS MILLS
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State | MD
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Zip | 21117-4579
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Country | US
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Telephone | 410-382-8741
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Fax |
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Provider Business Mailing Address
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Address Line | 3106 NORTHBROOK RD
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City | PIKESVILLE
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State | MD
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Zip | 21208-4523
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Country | US
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Telephone | 410-382-8741
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Fax |
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Authorized Official
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Title or Position | LCSW-C
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Name | OVADIA GOLFEIZ
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Credential |
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Telephone | 410-382-8741
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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