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General NPI Number Information
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NPI Number | 1932085149
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Entity Type | Organization
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Legal Business Name | EARLY LENS NEUROBEHAVIORAL CENTER
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Dates
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Enumeration Date | 08/13/2025
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Last Update Date | 10/15/2025
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Provider Practice Location Address
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Address Line | 1900 N HOWARD ST STE 101
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City | BALTIMORE
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State | MD
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Zip | 21218-5909
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Country | US
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Telephone | 410-705-0957
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Fax |
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Provider Business Mailing Address
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Address Line | 3 FALLON CT APT J
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City | NOTTINGHAM
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State | MD
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Zip | 21236-5170
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Country | US
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Telephone | 410-705-0957
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. JAVRON SHAKIR KEENE
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Credential | M.S., BCBA, LBA
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Telephone | 410-705-0957
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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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 | 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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Taxonomy #3
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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