BROOK LANE BEHAVIORAL SERVICES, INC. (NPI# 1063721512) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063721512 |
| Entity Type | Organization |
| Organization Name | BROOK LANE BEHAVIORAL SERVICES, INC. |
| Other Organization Name | BROOK LANE BUCKEYSTOWN |
| Practice Address |
5301 Buckeystown Pike Suite 170 Frederick MD 21704-8370 |
| Mailing Address |
13121 Brook Lane Hagerstown MD 21742-1435 |
| Practice Telephone | 3017330330 |
| Practice Fax Number | 3017334038 |
| Mailing Telephone | 3017330330 |
| Mailing Fax Number | 3017334038 |
| Enumeration Date | 2010-10-01 |
| 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 | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Brook Lane Buckeystown | Other Name - Individual/Organization |
| 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 |
| 1003304106 | Brook Lane Behavioral Services, Inc. | Clinic/Center | 18714 N Village, Hagerstown, MD 21742-2454 | 2018-04-25 |
| 1871983320 | Brook Lane Behavioral Services, Inc. | Counselor | 4540 B-d Mack Ave, Frederick, MD 21701 | 2015-02-04 |
| 1417928151 | Brook Lane Behavioral Services, Inc. | Clinic/Center | 18714 N Village, Shopping Center, Hagerstown, MD 21742-2454 | 2006-01-31 |
| Street Address |
5301 BUCKEYSTOWN PIKE SUITE 170 |
| City | FREDERICK |
| State | MD |
| Zip Code | 21704-8370 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972584233 | Andrew B. Johnson | Psychiatry & Neurology | 5301 Buckeystown Pike, Frederick, MD 21704-8370 | 2005-11-14 |
| 1366093098 | Shannon Snowman | Student in an Organized Health Care Education/Training Program | 5301 Buckeystown Pike, Stet 170, Frederick, MD 21704 | 2019-09-24 |
| 1538657630 | Brook Lane Behavioral Services, Inc. | Clinic/Center | 5301 Buckeystown Pike, Frederick, MD 21704-8370 | 2018-04-25 |
| 1649624198 | Mary Noble | Counselor | 5301 Buckeystown Pike, Frederick, MD 21704-8370 | 2016-04-21 |
| 1558715185 | Melissa Crigger | Counselor | 5301 Buckeystown Pike, Frederick, MD 21704-8370 | 2016-04-20 |
| 1174986558 | Marta Menendez-voss | Social Worker | 5301 Buckeystown Pike, Frederick, MD 21704-8370 | 2016-04-01 |
| 1942688379 | Evan Nathan Dickstein | Registered Nurse | 5301 Buckeystown Pike, Frederick, MD 21704-8370 | 2015-05-18 |
| 1962890962 | Emily Collingham | Counselor | 5301 Buckeystown Pike, Frederick, MD 21704-8370 | 2014-12-30 |
| 1518361690 | Maria Murphy | Counselor | 5301 Buckeystown Pike, Frederick, MD 21704-8370 | 2014-10-17 |
| 1932511714 | James Arthur Schiller | Social Worker | 5301 Buckeystown Pike, Frederick, MD 21704-8370 | 2014-05-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144747148 | Danah Jack | Physical Therapist | 4070 Atterbury Place, Frederick, MD 21704 | 2017-08-29 |
| 1568986891 | Amy Benjamin Slp | Speech-Language Pathologist | 8905 Amelung St, Frederick, MD 21704 | 2017-07-28 |
| 1104352368 | Mentor-maryland | Community/Behavioral Health | 5970 Frederick Crossing Lane, #202, Frederick, MD 21704 | 2017-05-10 |
| 1699193284 | Jiang Tan | Acupuncturist | 3520 Worthington Blvd #101, Frederick, MD 21704 | 2014-04-01 |
| 1326460817 | Jessica Lacayo | Nurse Practitioner | 3350 Worthington Boulevard, Urbana, MD 21704 | 2014-01-17 |
| 1588098818 | Kimberly Kaye Dipietro | Registered Nurse | 9006 Harris Street, Frederick, MD 21704 | 2013-08-22 |
| 1831432525 | Yuqing Meng | Pharmacist | 9317 Elgin Lane, Frederick, MD 21704 | 2013-04-01 |
| 1831446285 | Diane Marie Foland | Behavioral Analyst | 4235 Lafayette Street, Frederick, MD 21704 | 2012-08-03 |
| 1982932695 | Contemporary Therapeutic Services Inc | Community/Behavioral Health | 22 N Potomac Street, Ste 102, Hagerstown, MD 21704 | 2009-11-19 |
| 1942461181 | Hoa T K Lam | Dentist | 7360 Guilford Drive, Suite #102, Frederick, MD 21704 | 2008-06-20 |
| Find all providers in zip 21704 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144852187 | Open Arms, Open Minds Behavioral Health Services | Clinic/Center | 365 W Patrick St Ste 202, Frederick, MD 21701-4854 | 2020-02-07 |
| 1851866065 | Main Place Treatment Centers LLC. | Clinic/Center | 127 S. Smallwood Street, Frederick, MD 21701 | 2018-10-04 |
| 1033381892 | Lds Family Services | Clinic/Center | 172 Thomas Johnson Drive, Suite 200, Frederick, MD 21702-4404 | 2008-04-01 |
| 1659978732 | Mental Health Association of Frederick County | Clinic/Center | 226 S Jefferson St, Frederick, MD 21701-6205 | 2020-10-02 |
| 1104434281 | Keeley Psychiatry LLC | Clinic/Center | 5100 Buckeystown Pike Ste 250, Frederick, MD 21704-8344 | 2020-07-15 |
| 1003453366 | Maryland Center for Gender & Intimacy | Clinic/Center | 319 W Patrick St, Frederick, MD 21701-4855 | 2019-12-05 |
| 1871063685 | Genesis Treatment Services, LLC | Clinic/Center | 1160 W Patrick St, Frederick, MD 21703-3962 | 2018-12-05 |
| 1336614536 | Main Place Treatment Centers LLC. | Clinic/Center | 915 Toll House Ave Ste 102, Frederick, MD 21701-5911 | 2018-10-04 |
| 1427548569 | Mindful Marriage and Family Therapy, LLC | Clinic/Center | 120 W Church St Ste 3b, Frederick, MD 21701-7813 | 2018-05-15 |
| 1295243186 | Crazy Talk, LLC | Clinic/Center | 65 Thomas Johnson Dr Ste A, Frederick, MD 21702-4371 | 2018-01-14 |
| Find all providers in FREDERICK | ||||
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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.