PHOENIX THERAPEUTIC FOUNDATION (NPI# 1336333079) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336333079 |
| Entity Type | Organization |
| Organization Name | PHOENIX THERAPEUTIC FOUNDATION |
| Practice Address |
5602 Baltimore National Pike Suburbia Bldg - Suite # 508/6 Baltimore MD 21228-1411 |
| Mailing Address |
5602 Baltimore National Pike Suite 700 Baltimore MD 21228-1411 |
| Practice Telephone | 4107449100 |
| Practice Fax Number | 4107470226 |
| Mailing Telephone | 4107449100 |
| Mailing Fax Number | 4107470226 |
| Enumeration Date | 2007-09-05 |
| Last Update Date | 2012-09-27 |
| Authorized Official Name | MR. AMR A EL-BESHIR (CEO/PROGRAM DIRECTOR) |
| Authorized Official Telephone | 4107449100 |
| Authorized Official Credential | M.A. |
| Is Organization Subpart | Y |
| Parent Organization Name | PHOENIX THERAPEUTIC FOUNDATION |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | D0016432 | MD | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | 401254200 | 05 |
| Street Address |
5602 BALTIMORE NATIONAL PIKE SUBURBIA BLDG - SUITE # 508/6 |
| City | BALTIMORE |
| State | MD |
| Zip Code | 21228-1411 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992771265 | Delhi Thweatt Jr. | Specialist | 5602 Baltimore National Pike, 300, Baltimore, MD 21228-1411 | 2006-02-27 |
| 1184031676 | Jena Raymond | Counselor | 5602 Baltimore National Pike, Suite 302b, Baltimore, MD 21228-1411 | 2014-07-16 |
| 1184983637 | Phoenix Therapeutic Foundation, Inc | Counselor | 5602 Baltimore National Pike, Suite 700, Baltimore, MD 21228-1411 | 2012-05-03 |
| 1366769184 | Klc Pharmacy | Pharmacy | 5602 Baltimore National Pike, Ste 100, Baltimore, MD 21228-1411 | 2010-05-03 |
| 1235304189 | Thomas M Burggman | Counselor | 5602 Baltimore National Pike, Suite 508, Baltimore, MD 21228-1411 | 2008-04-22 |
| 1992979025 | Heather N Chapman | Social Worker | 5602 Baltimore National Pike, Suite 508, Baltimore, MD 21228-1411 | 2008-04-18 |
| 1073713970 | Anthony Alberto Campbell | Social Worker | 5602 Baltimore National Pike, Suite # 506, Baltimore, MD 21228-1411 | 2007-07-19 |
| 1023218997 | Delores Ann Mack | Social Worker | 5602 Baltimore National Pike, Suit # 506, Baltimore, MD 21228-1411 | 2007-07-19 |
| 1447474366 | Theresa Marlene Ridley | Social Worker | 5602 Baltimore National Pike, Baltimore, MD 21228 | 2007-04-12 |
| 1265554315 | Horace Greely Ward Jr. | Obstetrics & Gynecology | 5602 Baltimore National Pike, Suite 600, Baltimore, MD 21228-1411 | 2007-04-06 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699307975 | Playful Minds | Social Worker | 1009 Frederick Road, Baltimore, MD 21228 | 2020-02-05 |
| 1649818329 | Resolute Medical Care LLC | Nurse Practitioner | 4 E. Rolling Crossroads, Ste 100, Catonsville, MD 21228 | 2019-12-13 |
| 1760020416 | Bh Brightview Rolling Hills Opco, LLC | Alzheimer Center (Dementia Center) | 848 South Rolling Road, Catonsville, MD 21228 | 2019-12-12 |
| 1912542812 | Tiana Green | Counselor | 606 Edmondson Ave., Catonsville, MD 21228 | 2019-11-14 |
| 1699324806 | Maryland Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 4701 Wilkens Ave, Catonsville, MD 21228 | 2019-09-10 |
| 1528613460 | Hyung Joon Kim Dds PC | Dentist | 516 N. Rolling Rd, #201, Catonsville, MD 21228 | 2019-08-07 |
| 1982109658 | William Jones | Counselor | 29 Tentmill Lane, Pikesville, MD 21228 | 2018-03-26 |
| 1740783752 | Jean Walter Infusion Center, LLC | Clinic/Center | 700 Geipe Road St. 100, Catonsville, MD 21228 | 2018-03-15 |
| 1174036578 | Ideal Telemedicine Services, LLC | Clinic/Center | 516 N Rolling Rd Ste 301, Catonsville, MD 21228 | 2017-11-08 |
| 1932627239 | Mind Over Matter Health Services, Inc. | Community/Behavioral Health | 616 Old Edmondson Ave. Ste. 4, Baltimore, MD 21228 | 2017-09-07 |
| Find all providers in zip 21228 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366043127 | Ch Mh Services (md), LLC | Community/Behavioral Health | 12 W Montgomery St Ste 107, Baltimore, MD 21230-4490 | 2020-11-06 |
| 1568062099 | Borderless Healthcare Services, LLC | Community/Behavioral Health | 1900 E Northern Pkwy Ste 308, Baltimore, MD 21239-2111 | 2020-10-26 |
| 1982211322 | Brenda Bivens Wilson | Community/Behavioral Health | 1726 Bolton St, Baltimore, MD 21217-4904 | 2020-09-29 |
| 1366056855 | The Wel Foundation, LLC. | Community/Behavioral Health | 5858 Belair Rd, Baltimore, MD 21206-2661 | 2020-09-02 |
| 1679185177 | Center for Youth and Families Inc | Community/Behavioral Health | 6304 Elinore Ave, Baltimore, MD 21206-1721 | 2020-08-18 |
| 1457977100 | Apex Wellness Group, LLC | Community/Behavioral Health | 118 E 25th St Unit 2, Baltimore, MD 21218-5281 | 2020-06-18 |
| 1922622737 | Johns Hopkins Bayview Medical Center, Inc. | Community/Behavioral Health | 5500 E. Lombard Street, Room 1025, Baltimore, MD 21224 | 2020-06-08 |
| 1669093829 | Upcoming Enterprize Corporation | Community/Behavioral Health | 6615 Reisterstown Rd Ste Ll2, Baltimore, MD 21215-2686 | 2020-04-29 |
| 1922629344 | Providing Empowerment Advocacy & Social Skills | Community/Behavioral Health | 2361 Flax Ter, Baltimore, MD 21209-4625 | 2020-04-27 |
| 1801415153 | New Life Family Services LLC | Community/Behavioral Health | 3010 Ridgewood Ave Ste 210, Baltimore, MD 21215-6211 | 2020-04-15 |
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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.