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General NPI Number Information
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NPI Number | 1760304117
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Entity Type | Organization
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Legal Business Name | CEDAR RIDGE COUNSELING CENTERS LLC
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Dates
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Enumeration Date | 07/28/2026
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Last Update Date | 07/29/2026
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Provider Practice Location Address
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Address Line | 2300 YORK RD STE 106
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City | TIMONIUM
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State | MD
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Zip | 21093-2275
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Country | US
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Telephone | 410-552-0773
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Fax | 443-200-0267
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Provider Business Mailing Address
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Address Line | PO BOX 1229
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City | ELDERSBURG
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State | MD
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Zip | 21784-1229
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Country | US
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Telephone | 410-552-0773
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Fax | 443-200-0267
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Authorized Official
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Title or Position | CEO/DIRECTOR
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Name | TINA FRY
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Credential |
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Telephone | 410-552-0773
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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 |
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