Organization
MARCELLUS R CEPHAS MD LLC
Active
Parent organization
MARCELLUS R. CEPHAS MD LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
MARCELLUS R. CEPHAS MD LLC
Authorized official
DR. MARCELLUS RYAN CEPHAS M.D. (MEDICAL DIRECTOR, OWNER)
(301) 891-2077
Entity
Organization
Contact information
Practice address
1916 CRAIN HIGHWAY, SUITE 12, GLEN BURNIE, MD 21061-5563
(410) 487-6302
(301) 576-7397
Mailing address
7610 CARROLL AVENUE, SUITE 470, TAKOMA PARK, MD 20912
(301) 891-2077
(301) 576-7397
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LC3762
MD
103TP0016X
Prescribing (Medical) Psychologist
Primary
D0059532
MD
103TP0016X
Prescribing (Medical) Psychologist
R193679
MD
1041C0700X
Clinical Social Worker
13814
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
803307201
—
MD
01
—
G01202
P/10
MD
Enumeration date
06/17/2015
Last updated
07/31/2024
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