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General NPI Number Information
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NPI Number | 1770257651
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Entity Type | Organization
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Legal Business Name | NEDA KAVEH LLC
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Dates
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Enumeration Date | 08/04/2021
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Last Update Date | 08/04/2021
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Provider Practice Location Address
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Address Line | 5052 DORSEY HALL DR STE 102
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City | ELLICOTT CITY
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State | MD
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Zip | 21042-7797
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Country | US
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Telephone | 410-428-4099
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Fax |
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Provider Business Mailing Address
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Address Line | 8084 BALTIMORE NATIONAL PIKE SUITE 3210 #275
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City | ELLICOTT CITY
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State | MD
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Zip | 21043
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Country | US
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Telephone | 410-428-4099
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. SONYA NEDA KAVEH
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Credential | MD
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Telephone | 410-428-4099
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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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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number |
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License Number State |
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