Individual provider · Type 1 NPI
Eathell Bernice Lewis
Mental Health Clinic/Center (Including Community Mental Health Center) · Randallstown, MD
NPI number
1043970510
Active
Practice location
9331 Liberty Rd Suite 2C
Randallstown, MD 21133-3525
Mailing address
3812 Sandy Hook Road 3812 Sand
Randallstown, MD 21133
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Counselor | 101Y00000X | None listed |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | None listed |
| Mental Health Counselor | 101YM0800X | None listed |
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | 211011733 (MD) |
| Mental Health Clinic/Center (Including Community Mental Health Center) Primary | 261QM0801X | 21011733 |
Mental Health Clinic/Center (Including Community Mental Health Center): Definition to come...
About NPI 1043970510
Eathell Bernice Lewis's National Provider Identifier is 1043970510, issued on Dec 27, 2021. The primary taxonomy on file is Mental Health Clinic/Center (Including Community Mental Health Center) (261QM0801X), and the practice location is in Randallstown, MD. The record was last updated on Mar 7, 2022.