Organization · NPI-2

Alcohol And Drug Intervention

Counselor, Mental Health · Glen Burnie, MD

NPI number1427449172

StatusActive

Last updated in NPPESDec 8, 2020

Details

NPI: 1427449172
Entity type: Organization (NPI-2)
Legal business name: Alcohol And Drug Intervention
Organization subpart: No
Enumeration date: Feb 16, 2015
Certification date: Dec 8, 2020
Last updated: Dec 8, 2020

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
101YM0800X	Counselor, Mental Health	–	–	Yes
363L00000X	Nurse Practitioner	–	–

Practice location

7458 Baltimore Annapolis Blvd
2nd Floor
Glen Burnie, MD 21061-3541

Phone 410-787-2288 · Fax 410-787-9479

Mailing address

7458 Baltimore Annapolis Blvd
Glen Burnie, MD 21061-3541

Phone 410-787-2288 · Fax 410-787-9479

Authorized official

Mindy Fleetwood
President
4107872288

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.