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General NPI Number Information
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NPI Number | 1942659248
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Entity Type | Organization
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Legal Business Name | UPPER BAY COUNSELING&SUPPORT SERVICES
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Dates
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Enumeration Date | 06/07/2016
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Last Update Date | 06/07/2016
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Provider Practice Location Address
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Address Line | 200 BOOTH ST
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City | ELKTON
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State | MD
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Zip | 21921-5657
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Country | US
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Telephone | 410-996-3000
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Fax | 410-398-3416
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Provider Business Mailing Address
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Address Line | 200 BOOTH ST
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City | ELKTON
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State | MD
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Zip | 21921-5657
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Country | US
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Telephone | 410-996-3000
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Fax | 410-398-3416
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Authorized Official
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Title or Position | CEO
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Name | MR. RICH BAYER
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Credential | PH.D
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Telephone | 410-996-3000
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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 | MH1329
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License Number State | MD
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