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Organization
GEMINI HEALTH HOLDINGS LLC
Active
Organization
GEMINI HEALTH HOLDINGS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STACI POWELL DO (BILLING MANAGER)
(301) 703-8767
Entity
Organization
Contact information
Practice address
6816 DEERPATH RD, SUITE 201 AND 107, ELKRIDGE, MD 21075
(301) 703-8767
(301) 703-8886
Mailing address
2702 BACK ACRE CIR STE 290B, MOUNT AIRY, MD 21771-7769
(301) 703-8767
(301) 703-8886
Taxonomy
Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
Primary
—
NULL
103TA0400X
Addiction (Substance Use Disorder) Psychologist
Primary
—
—
103TC0700X
Clinical Psychologist
—
NULL
103TC0700X
Clinical Psychologist
—
—
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
—
NULL
Other
Enumeration date
03/13/2020
Last updated
03/13/2020
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