Organization
THE BEACON CLINIC LLC
Active
Other names
The Beacon Clinic LLC
Organization subpart
No
Provider details
NPI number
Authorized official
LUBNA SAMEH NABULSI B.S., M.S., CCC-SLP (CLINICAL DIRECTOR)
(443) 228-3458
Entity
Organization
Contact information
Practice address
600 WYNDHURST AVE STE 245C, BALTIMORE, MD 21210-2436
(443) 228-3458
(443) 292-6938
Mailing address
600 WYNDHURST AVE STE 245C, BALTIMORE, MD 21210-2436
(443) 228-3458
(443) 292-6938
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
009732369
UNITEDHEALTHCARE
MD
01
—
0315614
CIGNA
MD
05
—
228256900
—
MD
01
—
8452974
AETNA
MD
01
—
ZW870000
CAREFIRST
MD
Enumeration date
05/28/2024
Last updated
02/23/2026
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