Provider Type Icon

EVERGREEN MENTAL HEALTH SERVICES INC. NPI 1083013999


NPI Information

NPI: 1083013999
Provider Name: EVERGREEN MENTAL HEALTH SERVICES, INC.
Classification: Psychiatry & Neurology - 2084P0800X
Entity Type: Organization

Specialization: Psychiatry

Address:
1645 RIDGELY ST
SUITE 100
BALTIMORE, MD
ZIP 21230
Phone: (240) 251-4702
Get Directions

EVERGREEN MENTAL HEALTH SERVICES, INC. is a psychiatry psychiatry neurology in Baltimore, MD. The provider is a Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. EVERGREEN MENTAL HEALTH SERVICES, INC. NPI is 1083013999. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1645 RIDGELY ST
SUITE 100
BALTIMORE, MD
ZIP 21230-050
Phone: (240) 251-4702
Fax: (301) 251-4703

The provider's authorized official is Barton Azwalinsky .
The authorized official title is Ceo and has the following contact phone number (301) 251-4702.

The enumeration date for this NPI number is 8/15/2014 and was last updated on 6/23/2017.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1101YM0800XCounselorMental HealthNo
2103T00000XPsychologistNo
3104100000XSocial WorkerNo
4364SP0808XClinical Nurse SpecialistPsychiatric/Mental HealthNo
52084P0800XPsychiatry & NeurologyPsychiatryYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1B99125MEDICARE UPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.