Organization
UPPER BAY COUNSELING & SUPPORT SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SUANNE BLUMBERG LCPC (CEO)
(410) 996-5104
Entity
Organization
Contact information
Practice address
200 BOOTH STREET, ELKTON, MD 21921
(410) 996-5104
(410) 996-5197
Mailing address
200 BOOTH STREET, ELKTON, MD 21921
(410) 996-5104
(410) 996-5197
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
922500500
MEDICAID INTENSIVE CASE M
MD
05
—
922801200
—
MD
01
—
922900100
MEDICAID REHAB
MD
Enumeration date
02/21/2006
Last updated
07/14/2021
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