# STREET ANGEL PROJECT PEER RECOVERY SERVICES

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

## Provider details

- **NPI number:** 1437822665
- **Authorized official:** SHIRLEY L GORDON CSAC,CMHT, CPRS, (OWNER)
- **Authorized official phone:** (443) 949-9545

## Contact information

- **Practice address:** 92 W WASHINGTON ST, ANNAPOLIS, MD 21401-2432
- **Practice address phone:** (443) 949-9545
- **Mailing address:** 55 CLAY ST, ANNAPOLIS, MD 21401-2402
- **Mailing address phone:** (443) 591-2434
- **Mailing address fax:** (240) 336-0055

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | NULL | Yes |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | — | Yes |
| 175T00000X | Peer Specialist | — | NULL | — |
| 175T00000X | Peer Specialist | — | — | — |
| 251S00000X | Community/Behavioral Health Agency | — | NULL | — |

## Other

- **Enumeration date:** 07/25/2021
- **Last updated:** 10/05/2021