Organization · NPI-2

Collective Transformation Health Services

Clinic/Center, Mental Health (Including Community Mental Health Center) · Edgewater, MD

NPI number1386163020

StatusActive

Last updated in NPPESJul 21, 2022

Details

NPI: 1386163020
Entity type: Organization (NPI-2)
Legal business name: Collective Transformation Health Services
Organization subpart: No
Enumeration date: Sep 13, 2017
Last updated: Jul 21, 2022

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
261QM0801X	Clinic/Center, Mental Health (Including Community Mental Health Center)	–	–	Yes
101YP2500X	Counselor, Professional	–	–
224Z00000X	Occupational Therapy Assistant	–	–
101YS0200X	Counselor, School	–	–
1041C0700X	Social Worker, Clinical	–	–
225100000X	Physical Therapist	–	–
235Z00000X	Speech-Language Pathologist,	–	–
251B00000X	Case Management	–	–
251K00000X	Public Health or Welfare	–	–
251S00000X	Community/Behavioral Health	–	–
261QM0855X	Clinic/Center, Adolescent and Children Mental Health	–	–
261QR0400X	Clinic/Center, Rehabilitation	–	–

Practice location

1642 Shady Side Dr.
Edgewater, MD 21037

Phone 410-401-3621

Mailing address

1642 Shady Side Dr
Edgewater, MD 21037-1934

Phone 410-956-6000

Authorized official

Sophia Acquah
Program Director
4109566000

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.