Provider Demographics
NPI:1154310225
Name:UNIVERSAL COUNSELING SERVICES, INC.
Entity type:Organization
Organization Name:UNIVERSAL COUNSELING SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHULDEN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-C
Authorized Official - Phone:410-752-5525
Mailing Address - Street 1:1401 SEVERN ST STE 201
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21230-1740
Mailing Address - Country:US
Mailing Address - Phone:410-752-5525
Mailing Address - Fax:
Practice Address - Street 1:1401 SEVERN ST STE 201
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21230-1740
Practice Address - Country:US
Practice Address - Phone:410-752-5525
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-20
Last Update Date:2011-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDKC29OtherCAREFIRST/BLUE CROSS/BLUE
MDT514OtherBLUE CHOICE
MD215468000OtherMAGELLAN
MD212150600Medicaid
MDT514OtherBLUE CHOICE