# BALTIMORE CENTER FOR PSYCHOTHERAPY LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1033839667
- **Authorized official:** KATHLEEN FANONE LCSW-C (CO-DIRECTOR)
- **Authorized official phone:** (240) 412-8880

## Contact information

- **Practice address:** 623 W 34TH ST STE 105, BALTIMORE, MD 21211-2658
- **Practice address phone:** (443) 873-0635
- **Mailing address:** 1716 BOLTON ST, BALTIMORE, MD 21217-4323
- **Mailing address phone:** (240) 412-8880

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | Yes |
| 101YM0800X | Mental Health Counselor | — | — | Yes |

## Other

- **Enumeration date:** 09/01/2022
- **Last updated:** 09/01/2022