Provider Demographics
NPI:1346047800
Name:PERSAUD, BHAVNA
Entity type:Individual
Prefix:
First Name:BHAVNA
Middle Name:
Last Name:PERSAUD
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8005 HARFORD RD STE 101
Mailing Address - Street 2:
Mailing Address - City:PARKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21234-5753
Mailing Address - Country:US
Mailing Address - Phone:443-707-8319
Mailing Address - Fax:
Practice Address - Street 1:8005 HARFORD RD STE 101
Practice Address - Street 2:
Practice Address - City:PARKVILLE
Practice Address - State:MD
Practice Address - Zip Code:21234-5753
Practice Address - Country:US
Practice Address - Phone:443-707-8319
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-03
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker