PREMIERE THERAPEUTIC SERVICES LLC NPI 1740587179

NPI Information

NPI: 1740587179
Provider Name: PREMIERE THERAPEUTIC SERVICES, LLC
Classification: Counselor - 101YP2500X
Entity Type: Organization

Specialization: Professional

Address:
5516 TODD AVE
BALTIMORE, MD
ZIP 21206
Phone: (410) 615-2931
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PREMIERE THERAPEUTIC SERVICES, LLC is a professional counselor in Baltimore, MD. PREMIERE THERAPEUTIC SERVICES, LLC NPI is 1740587179. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

5516 TODD AVE
BALTIMORE, MD
ZIP 21206-721
Phone: (410) 615-2931

The provider's authorized official is Jabir Na'im Pasha .
The authorized official title is Clinical Director and has the following contact phone number (410) 885-4500.

The enumeration date for this NPI number is 2/21/2011 and was last updated on 4/9/2012.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YP2500X	Counselor	Professional	LC2117	MARYLAND	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0244686 00	MEDICAID	MARYLAND
2	5542251	MEDICAID	MARYLAND

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: 4/28/2024

NPI Synchronization or Removal

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