Organization
CLINICAL SOLUTIONS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM CHARLES EDMUNDS (HUMAN RESOURCE)
(410) 372-7628
Entity
Organization
Contact information
Practice address
4000 BLACKBURN LN STE 150, BURTONSVILLE, MD 20866-6127
(310) 421-4241
(888) 317-2075
Mailing address
4000 BLACKBURN LN STE 150, BURTONSVILLE, MD 20866-6127
(301) 421-4241
(888) 317-2075
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
103TC0700X
Clinical Psychologist
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
103TM1800X
Intellectual & Developmental Disabilities Psychologist
—
—
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
—
—
Other
Enumeration date
10/17/2016
Last updated
05/05/2021
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