Organization
EVERGREEN MENTAL HEALTH SERVICES, INC.
Active
Parent organization
EVERGREEN MENTAL HEALTH SERVICES, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
EVERGREEN MENTAL HEALTH SERVICES, INC.
Authorized official
BARTON AZWALINSKY (CEO)
(301) 251-4702
Entity
Organization
Contact information
Practice address
1645 RIDGELY ST, SUITE 100, BALTIMORE, MD 21230-2050
(240) 251-4702
(301) 251-4703
Mailing address
9318 GAITHER RD STE 220, GAITHERSBURG, MD 20877-1407
(240) 251-4702
(301) 251-4703
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103T00000X
Psychologist
—
—
104100000X
Social Worker
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
—
—
Other
Enumeration date
08/15/2014
Last updated
07/21/2022
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