Organization
PSYCHIATRY SPECIALITIES CLINICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS RINU PRADHAN (OFFICE MANAGER)
(410) 988-8092
Entity
Organization
Contact information
Practice address
3525 ELLICOTT MILLS DR STE G, ELLICOTT CITY, MD 21043-4638
(410) 988-8092
(443) 420-7875
Mailing address
3525 ELLICOTT MILLS DR, ELLICOTT CITY, MD 21043-4547
(410) 988-8092
(443) 420-7875
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
2084P0800X
Psychiatry Physician
—
—
2084P0802X
Addiction Psychiatry Physician
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
345025200
—
MD
Enumeration date
01/09/2019
Last updated
10/10/2023
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