Provider Demographics
NPI:1972364693
Name:PIKESVILLE BEHAVIORAL HEALTH CENTER
Entity type:Organization
Organization Name:PIKESVILLE BEHAVIORAL HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MALKA
Authorized Official - Middle Name:
Authorized Official - Last Name:DUBIN
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:443-641-3239
Mailing Address - Street 1:2807 BARTOL AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21209-3903
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1212 YORK RD STE A302
Practice Address - Street 2:
Practice Address - City:TIMONIUM
Practice Address - State:MD
Practice Address - Zip Code:21093-6245
Practice Address - Country:US
Practice Address - Phone:443-641-3239
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-19
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)