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Organization
ANTHEM BEHAVIORAL HEALTH, LLC
Active
Organization
ANTHEM BEHAVIORAL HEALTH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER PETRIK (CEO)
(443) 567-6091
Entity
Organization
Contact information
Practice address
404 N HICKORY AVE, BEL AIR, MD 21014-3227
(410) 459-7699
Mailing address
404 N HICKORY AVE, BEL AIR, MD 21014-3227
(443) 567-6091
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
NULL
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
NULL
101YP2500X
Professional Counselor
—
—
1041C0700X
Clinical Social Worker
—
NULL
1041C0700X
Clinical Social Worker
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
09/25/2023
Last updated
02/13/2025
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