MEDICARE: GUIDE PROGRAM, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1437273372
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GUIDE PROGRAM, INC

Provider Business Mailing Address
First Line	:	8643 CHERRY LN
Second Line	:
City	:	LAUREL
State	:	MD
Zip	:	20707-6200
Country	:	US
Telephone Number	:	301-549-3602
Fax Number	:	301-549-3605

Provider Business Practice Location Address
First Line	:	5508 KAREN ELAINE DR
Second Line	:	824
City	:	NEW CARROLLTON
State	:	MD
Zip	:	20784-4131
Country	:	US
Telephone Number	:	301-459-8220
Fax Number	:	301-577-1756

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR & PRESIDENT
Name	:	MR. SCOTT K. BIRDSONG
Credential	:	LCSW-C
Telephone Number	:	301-549-3602

Provider Enumeration Date	:	03/18/2007
Last Update Date	:	08/22/2020

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Directions to “GUIDE PROGRAM, INC ” Practice Location

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