# MOSAIC COMMUNITY SERVICES-NBC

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

## Provider details

- **NPI number:** 1154632024
- **Authorized official:** MR. JEFF RICHARDSON LCSW-C (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (410) 453-9553

## Contact information

- **Practice address:** 2225 N CHARLES ST, BALTIMORE, MD 21218-5778
- **Practice address phone:** (410) 366-4360
- **Mailing address:** 1925 GREENSPRING DR, TIMONIUM, MD 21093-4128
- **Mailing address phone:** (410) 453-9553
- **Mailing address fax:** (410) 308-8926

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | Yes |
| 101YM0800X | Mental Health Counselor | — | — | Yes |
| 103TC1900X | Counseling Psychologist | — | NULL | — |
| 103TC1900X | Counseling Psychologist | — | — | — |

## Other

- **Enumeration date:** 06/25/2010
- **Last updated:** 06/25/2010