# CHASE BREXTON HEALTH SERVICES, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Chase Brexton Health Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1750687166
- **Authorized official:** MR. KYLE EASTON (REVENUE CYCLE DIRECTOR)
- **Authorized official phone:** (410) 837-2050

## Contact information

- **Practice address:** 3510 BRENBROOK DRIVE, RANDALLSTOWN, MD 21201-5442
- **Practice address phone:** (410) 496-6441
- **Practice address fax:** (410) 496-6448
- **Mailing address:** 1111 NORTH CHARLES STREET, BALTIMORE, MD 21201
- **Mailing address phone:** (410) 837-2050
- **Mailing address fax:** (410) 752-1374

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | — |
| 101YM0800X | Mental Health Counselor | — | — | — |
| 103T00000X | Psychologist | — | NULL | — |
| 103T00000X | Psychologist | — | — | — |
| 103TA0400X | Addiction (Substance Use Disorder) Psychologist | — | NULL | — |
| 103TA0400X | Addiction (Substance Use Disorder) Psychologist | — | — | — |
| 1041C0700X | Clinical Social Worker | — | NULL | — |
| 1041C0700X | Clinical Social Worker | — | — | — |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 2084P0800X | Psychiatry Physician | — | NULL | — |
| 2084P0800X | Psychiatry Physician | — | — | — |
| 213E00000X | Podiatrist | — | NULL | — |
| 213E00000X | Podiatrist | — | — | — |

## Other

- **Enumeration date:** 02/02/2011
- **Last updated:** 02/24/2020