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NPI 1558036962 · live from the CMS NPI Registry

1st Medical Pain Management Specialists

Clinic/Center, Adult Mental Health in Towson, MD. National Provider Identifier 1558036962, active.

NPI record

NPI1558036962 Type 2 · organization
StatusActive
Primary specialtyClinic/Center, Adult Mental Health 261QM0850X
Practice location7600 Osler Dr Ste 105, Towson, MD 21204
Practice phone410-825-4500
EnumeratedAugust 9, 2021
Last updatedJanuary 23, 2022
Authorized officialRosemary Ingado, Clinical Administrator
Other names1st Medical Painrehab Center

Taxonomies and licenses

TaxonomyCodeLicense
Counselor, Addiction (Substance Use Disorder)101YA0400X—
Counselor, Mental Health101YM0800X—
Social Worker, Clinical1041C0700X—
Rehabilitation Counselor225C00000X—
Clinic/Center, Multi-Specialty261QM1300X—
Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)261QR0401X—
Clinic/Center, Rehabilitation, Substance Use Disorder261QR0405X—
Clinic/Center, Recovery Care261QR0800X—
Clinic/Center, Adult Mental Health primary261QM0850X—

Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.