GAUDENZIA INC. NPI 1295181170

NPI Information

  • NPI: 1295181170
  • Provider Name: GAUDENZIA, INC.
  • Classification: Counselor - 101YA0400X
  • Specialization: Addiction (Substance Use Disorder)
  • Entity Type: Organization
  • Doing Business As: GAUDENZIA - GLEN BURNIE OUTPATIENT
  • CLIA Number: 21D2204816
  • Address: 5 CRAIN HIGHWAY NORTH - REAR SUITE ENTRANCE
    GLEN BURNIE, MD
    ZIP 21061
  • Phone: (443) 569-7950

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NPI Details

GAUDENZIA, INC. is an addiction (substance use disorder) counselor in Glen Burnie, MD. GAUDENZIA, INC. NPI is 1295181170. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Gaudenzia - Glen Burnie Outpatient.

The provider's business location address is:

5 CRAIN HIGHWAY NORTH - REAR SUITE ENTRANCE
GLEN BURNIE, MD
ZIP 21061
Phone: (443) 569-7950
Fax: (410) 367-1810

The provider's authorized official is Youthful Edrington .
The authorized official title is Credential Coordinator and has the following contact phone number (717) 980-1519.

The CLIA number assigned to this NPI record is 21D2204816 - other - residential tx with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/10/2016 and was last updated on 2/8/2023.

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
1101YA0400XCounselorAddiction (Substance Use Disorder)Yes

What is NPI?

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This page was last updated on: 3/30/2025

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