BROOK LANE BEHAVIORAL SERVICES, INC. (NPI# 1003304106) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003304106 |
| Entity Type | Organization |
| Organization Name | BROOK LANE BEHAVIORAL SERVICES, INC. |
| Practice Address |
18714 N Village Hagerstown MD 21742-2454 |
| Mailing Address |
13121 Brook Lane Hagerstown MD 21742-1514 |
| Practice Telephone | 3017330330 |
| Practice Fax Number | 3017334038 |
| Mailing Telephone | 3017330330 |
| Mailing Fax Number | 3017334038 |
| Enumeration Date | 2018-04-25 |
| Last Update Date | 2018-10-01 |
| Authorized Official Name | JAMIE LEA BARKDOLL (CRED COORDINATOR) |
| Authorized Official Telephone | 3017330331 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
BH000028 | MD | Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558648410 | Brook Lane Behavioral Services, Inc. | Psychiatric Hospital | 4540b Mack Avenue, Frederick, MD 21701 | 2011-11-07 |
| 1144703109 | Brook Lane Behavioral Services, Inc. | Psychiatric Hospital | 13215 Brook Lane, Hagerstown, MD 21742-1495 | 2018-09-14 |
| 1962985929 | Brook Lane Behavioral Services, Inc. | Psychiatric Unit | 13215 Brook Lane, Hagerstown, MD 21742 | 2018-09-14 |
| 1538647748 | Brook Lane Behavioral Services, Inc. | Counselor | 13215 Brook Lane, Outpatient Services, Hagerstown, MD 21742 | 2018-07-31 |
| 1538657630 | Brook Lane Behavioral Services, Inc. | Clinic/Center | 5301 Buckeystown Pike, Frederick, MD 21704-8370 | 2018-04-25 |
| 1871983320 | Brook Lane Behavioral Services, Inc. | Counselor | 4540 B-d Mack Ave, Frederick, MD 21701 | 2015-02-04 |
| 1063721512 | Brook Lane Behavioral Services, Inc. | Clinic/Center | 5301 Buckeystown Pike, Suite 170, Frederick, MD 21704-8370 | 2010-10-01 |
| 1417928151 | Brook Lane Behavioral Services, Inc. | Clinic/Center | 18714 N Village, Shopping Center, Hagerstown, MD 21742-2454 | 2006-01-31 |
| Street Address |
18714 N VILLAGE |
| City | HAGERSTOWN |
| State | MD |
| Zip Code | 21742-2454 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720065816 | Fred N Edell | Counselor | 18714 N Village, Hagerstown, MD 21742-2454 | 2005-12-29 |
| 1730799008 | Meritus Medical Center Inc | Clinic/Center | 18714 N Village, Hagerstown, MD 21742-2454 | 2020-08-03 |
| 1700414083 | Sabrina A Mccauley | Counselor | 18714 N Village, Hagerstown, MD 21742-2174 | 2020-03-31 |
| 1366091126 | Nasrene Nikpora | Student in an Organized Health Care Education/Training Program | 18714 N Village, Hagerstown, MD 21742-2454 | 2019-09-05 |
| 1518512037 | Christian Rock | Social Worker | 18714 N Village, Hagerstown, MD 21742-2454 | 2019-08-02 |
| 1114422565 | Shannon Bell | Social Worker | 18714 N Village, Hagerstown, MD 21742-2454 | 2018-03-28 |
| 1306341052 | Erica Riley | Social Worker | 18714 N Village, Hagerstown, MD 21742-2454 | 2018-03-26 |
| 1306392667 | Vanessa Koziol | Counselor | 18714 N Village, Hagerstown, MD 21742-2454 | 2016-08-28 |
| 1942654496 | Laura White | Social Worker | 18714 N Village, Hagerstown, MD 21742 | 2016-04-21 |
| 1437523560 | Elizabeth Riitano | Social Worker | 18714 N Village, Hagerstown, MD 21742-2454 | 2015-12-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154950251 | Caleb Lougheed | Student in an Organized Health Care Education/Training Program | Meritus Family Medicine Residency Program, 11110 Medical Campus Road, Suite 200, Hagerstown, MD 21742 | 2020-04-02 |
| 1770054900 | Katherine E Spann | Physician Assistant | Meritus Medical Center, 11116 Medical Campus Road, Hagerstown, MD 21742 | 2018-12-16 |
| 1760988950 | Kelli Jones | Nurse Anesthetist, Certified Registered | 11116 Medical Center, Hagerstown, MD 21742 | 2018-04-05 |
| 1740706324 | Michael E. Anderson, Dds, PC | Dentist | 18709 Crestwood Drive, Hagerstown, MD 21742 | 2017-08-16 |
| 1407387384 | Cynthia Brendle | Physical Therapy Assistant | 19800 Tranquility Circle, Robinwood Campus, Hagerstown, MD 21742 | 2017-03-23 |
| 1326411877 | Structural Elements, LLC | Acupuncturist | 13214 Fountainhead Plaza, Hagerstown, MD 21742 | 2015-11-05 |
| 1386057396 | Ma Pamela Borden | Occupational Therapist | 506 Lynnehaven Drive, Apartment G, Hagerstown, MD 21742 | 2014-06-06 |
| 1275971251 | Arti Babubhai Patel | Denturist | 13133 Gentry Drive, Hagerstown, MD 21742 | 2013-06-12 |
| 1063859551 | Premise Health of Maryland Medical P C | Clinic/Center | 13403 Volvo Way, Medical Suite, Hagerstown, MD 21742 | 2013-05-24 |
| 1386938363 | Rocky Mountain Holdings LLC | Ambulance | 18539 Henson Blvd, Hagerstown, MD 21742 | 2011-06-07 |
| Find all providers in zip 21742 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
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|---|---|---|---|---|
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| 1093287617 | Brooke's House, Inc. | Clinic/Center | 17670 Technology Boulevard, Hagerstown, MD 21740 | 2018-12-20 |
| 1922496892 | Wells House Inc | Clinic/Center | 128 E Baltimore St, Hagerstown, MD 21740-6104 | 2014-12-31 |
| 1568097608 | Bridge To Holistic Healing, LLC | Clinic/Center | 223 N Prospect St Ste 306, Hagerstown, MD 21740-3783 | 2020-03-10 |
| 1003387200 | Brooke's House, Inc. | Clinic/Center | 17666 Technology Blvd, Hagerstown, MD 21740-2074 | 2018-12-16 |
| 1376012401 | Wells House Inc | Clinic/Center | 324 N Locust St, Hagerstown, MD 21740-4059 | 2018-11-19 |
| 1841787132 | Associated Catholic Charities, Inc. | Clinic/Center | 324 E Antietam St Ste 307a, Hagerstown, MD 21740-5768 | 2018-04-23 |
| 1649636747 | Serenity Treatment Center, Inc. | Clinic/Center | 580 Northern Ave, Suite D, Hagerstown, MD 21742-2847 | 2016-01-06 |
| 1932187523 | Wells House Inc | Clinic/Center | 124 E Baltimore St, Hagerstown, MD 21740-6104 | 2006-01-04 |
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|---|---|---|---|---|
| 1043817075 | Maryland Community Health Initiatives, Inc. | Clinic/Center | 2648 Guilford Ave Apt 1fl, Baltimore, MD 21218-4611 | 2020-10-02 |
| 1851998892 | Maryland Community Health Initiatives, Inc. | Clinic/Center | 2648 Guilford Ave Apt 2fl, Baltimore, MD 21218-4611 | 2020-10-02 |
| 1801403324 | Maryland Community Health Initiatives, Inc. | Clinic/Center | 328 E 26th St, Baltimore, MD 21218-4702 | 2020-09-29 |
| 1275148975 | Hel Recovery Center | Clinic/Center | 1900 N Howard St Fl 2, Baltimore, MD 21218-5909 | 2020-09-10 |
| 1497365654 | Inspiring Change Mental Health Services, LLC. | Clinic/Center | 4654 York Rd Ste 1, Baltimore, MD 21212-4726 | 2020-08-03 |
| 1174132518 | Sabinas House LLC | Clinic/Center | 3103 Mareco Ave, Baltimore, MD 21213-1619 | 2020-07-30 |
| 1134738909 | Sabinas House LLC | Clinic/Center | 2224 Dukeland St, Baltimore, MD 21216-2812 | 2020-07-28 |
| 1881203792 | Sabinas House LLC | Clinic/Center | 3325 Shannon Dr, Baltimore, MD 21213-1823 | 2020-07-27 |
| 1356950265 | Sabinas House LLC | Clinic/Center | 616 Wildwood Pkwy, Baltimore, MD 21229-1810 | 2020-07-27 |
| 1598374407 | Sabinas House LLC | Clinic/Center | 605 Springfield Ave, Baltimore, MD 21212-4832 | 2020-07-27 |
| Find all providers with the same taxonomy | ||||
| City | HAGERSTOWN |
| Zip Code | 21742 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.