Organization
CARROLL COUNTY YOUTH SERVICE BUREAU, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LYNN DAVIS LCPC (EXECUTIVE DIRECTOR)
(443) 244-8649
Entity
Organization
Contact information
Practice address
59 KATE WAGNER RD., WESTMINSTER, MD 21157
(410) 848-2500
(410) 876-3016
Mailing address
59 KATE WAGNER RD, WESTMINSTER, MD 21157-6957
(410) 848-2500
(410) 876-3016
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
12225
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
615501400
—
MD
Enumeration date
12/27/2006
Last updated
02/15/2023
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