Provider Demographics
NPI:1215448998
Name:ASSOCIATED BEHAVIORAL HEALTH SERVICES, LLC
Entity type:Organization
Organization Name:ASSOCIATED BEHAVIORAL HEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO / SOCIAL WORKER
Authorized Official - Prefix:MR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:TODD
Authorized Official - Last Name:BOLIN
Authorized Official - Suffix:JR
Authorized Official - Credentials:LCSW-C
Authorized Official - Phone:443-588-8743
Mailing Address - Street 1:939 ELKRIDGE LANDING RD STE 350
Mailing Address - Street 2:
Mailing Address - City:LINTHICUM
Mailing Address - State:MD
Mailing Address - Zip Code:21090-2909
Mailing Address - Country:US
Mailing Address - Phone:443-354-8903
Mailing Address - Fax:443-410-0643
Practice Address - Street 1:939 ELKRIDGE LANDING RD STE 350
Practice Address - Street 2:
Practice Address - City:LINTHICUM
Practice Address - State:MD
Practice Address - Zip Code:21090-2909
Practice Address - Country:US
Practice Address - Phone:443-354-8903
Practice Address - Fax:443-410-0643
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-20
Last Update Date:2023-08-25
Deactivation Date:2023-07-31
Deactivation Code:
Reactivation Date:2023-08-25
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental HealthGroup - Multi-Specialty