# BLUE RIDGE BEHAVIORAL HEALTH SERVICES, LLC

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

## Provider details

- **NPI number:** 1508862392
- **Authorized official:** LAURIE M. LEPEONKE (OFFICE MANAGER)
- **Authorized official phone:** (301) 695-8390

## Contact information

- **Practice address:** 170 THOMAS JOHNSON DR, STE 200, FREDERICK, MD 21702-6200
- **Practice address phone:** (301) 695-8390
- **Practice address fax:** (301) 694-7906
- **Mailing address:** 170 THOMAS JOHNSON DR, STE 200, FREDERICK, MD 21702-6200
- **Mailing address phone:** (301) 695-8390
- **Mailing address fax:** (301) 694-7906

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | Yes |
| 101YM0800X | Mental Health Counselor | — | — | Yes |
| 103T00000X | Psychologist | — | NULL | — |
| 103T00000X | Psychologist | — | — | — |
| 1041C0700X | Clinical Social Worker | — | NULL | — |
| 1041C0700X | Clinical Social Worker | — | — | — |
| 235Z00000X | Speech-Language Pathologist | — | NULL | — |
| 235Z00000X | Speech-Language Pathologist | — | — | — |

## Other

- **Enumeration date:** 06/26/2005
- **Last updated:** 05/24/2013