Provider Demographics
NPI:1962183244
Name:BEHAVIOR HEALTH & ADDICTIONS CENTER, INCORPORATED
Entity type:Organization
Organization Name:BEHAVIOR HEALTH & ADDICTIONS CENTER, INCORPORATED
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:PROF
Authorized Official - First Name:PENNY
Authorized Official - Middle Name:D
Authorized Official - Last Name:GAUER
Authorized Official - Suffix:
Authorized Official - Credentials:LC12763
Authorized Official - Phone:443-650-3004
Mailing Address - Street 1:4518 HAWKSBURY RD
Mailing Address - Street 2:
Mailing Address - City:PIKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-2122
Mailing Address - Country:US
Mailing Address - Phone:443-650-3004
Mailing Address - Fax:
Practice Address - Street 1:1829 REISTERSTOWN RD
Practice Address - Street 2:
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208-6320
Practice Address - Country:US
Practice Address - Phone:301-755-8596
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-28
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty