# DAVIDS LOFT CENTER FOR SOMATIC AND BEHAVIORAL HEALTHCARE

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

## Provider details

- **NPI number:** 1992372312
- **Authorized official:** DAVID H THOMPSON JR. LCPC (CEO)
- **Authorized official phone:** (410) 800-4285

## Contact information

- **Practice address:** 2641 MARYLAND AVE, BALTIMORE, MD 21218-4518
- **Practice address phone:** (410) 800-4226
- **Mailing address:** 2641 MARYLAND AVE, BALTIMORE, MD 21218-4518
- **Mailing address phone:** (410) 800-4226

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 363LP2300X | Primary Care Nurse Practitioner | — | NULL | — |
| 363LP2300X | Primary Care Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 06/04/2021
- **Last updated:** 06/04/2021