Provider Demographics
NPI:1366058083
Name:THE HOUSE PROJECT
Entity type:Organization
Organization Name:THE HOUSE PROJECT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:JEAN
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:301-825-6265
Mailing Address - Street 1:1218 SARGEANT ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21223-3630
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5570 STERRETT PL STE 208
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-2649
Practice Address - Country:US
Practice Address - Phone:301-615-1007
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-17
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1-19-36416OtherBLUE CROSS
MD1-19-36416Medicaid