Provider Demographics
NPI:1285987479
Name:RICHARD YERACHMIEL DONOWITZ
Entity type:Organization
Organization Name:RICHARD YERACHMIEL DONOWITZ
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO AND PRACTIONER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:YERACHMIEL
Authorized Official - Last Name:DONOWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:404-633-6626
Mailing Address - Street 1:3107 SZOLD DR
Mailing Address - Street 2:
Mailing Address - City:PIKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-5631
Mailing Address - Country:US
Mailing Address - Phone:404-633-6626
Mailing Address - Fax:
Practice Address - Street 1:3107 SZOLD DR
Practice Address - Street 2:
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208-5631
Practice Address - Country:US
Practice Address - Phone:404-633-6626
Practice Address - Fax:678-802-2117
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-25
Last Update Date:2024-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD6002111Medicaid