Organization
CREATED FOR GREATER HEALTH SYSTEMS
Active
Parent organization
-
Organization subpart
Yes
Provider details
NPI number
Legal business name
-
Authorized official
LAKIA THOMPSON LCSW-C (CEO)
(443) 315-5007
Entity
Organization
Contact information
Practice address
1508 N CAROLINE ST, BALTIMORE, MD 21213-2804
(443) 315-5007
Mailing address
5411 OLD FREDERICK RD STE 9, BALTIMORE, MD 21229-2126
(443) 315-5007
(443) 251-5395
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
03/16/2020
Last updated
03/16/2020
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