PUDDS PLACE NPI 1619694239

NPI Information

NPI: 1619694239
Provider Name: PUDDS PLACE
Classification: Counselor - 101YA0400X
Entity Type: Organization

Specialization: Addiction (Substance Use Disorder)

Address:
2413 REISTERSTOWN RD APT 1
BALTIMORE, MD
ZIP 21217
Phone: (443) 633-3177
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PUDDS PLACE is an addiction (substance use disorder) counselor in Baltimore, MD. PUDDS PLACE NPI is 1619694239. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2413 REISTERSTOWN RD APT 1
BALTIMORE, MD
ZIP 21217-056
Phone: (443) 633-3177

The provider's authorized official is Sykia Edwards .
The authorized official title is Clinical Director and has the following contact phone number (443) 633-3177.

The enumeration date for this NPI number is 10/25/2022 and was last updated on 10/25/2022.

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	101YA0400X	Counselor	Addiction (Substance Use Disorder)			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	1093103756	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: 5/5/2024

NPI Synchronization or Removal

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