Organization · Type 2 NPI

The House of Jude Children Services

Mental Health Clinic/Center (Including Community Mental Health Center) · Baltimore, MD

NPI number 1376701193 Active

Practice location

420 E. 25th Street
Baltimore, MD 21218

Call (410) 705-1331 Map

Fax (410) 938-2237

Mailing address

P.o. Box 5004
Middle River, MD 21220

Specialties and licenses

Taxonomy	Code	License
Mental Health Counselor	101YM0800X	None listed
Professional Counselor	101YP2500X	NCC-93405 (MD)
Mental Health Clinic/Center (Including Community Mental Health Center) Primary	261QM0801X	LC-2284 (MD)

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NPI record

NPI: 1376701193
Entity type: Organization (Type 2)
Issued: May 29, 2008
Last updated: May 3, 2024
Status: Active
Subpart: Yes of The House of Jude Children Services

Other names

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The House of Jude Behavioral Health Services · doing business as
The House of Jude Behavioral Health Services · doing business as

Authorized official

Edith Augustson, NCC, LCPC, LCADC
Owner
(410) 705-1331

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1376701193

The House of Jude Children Services's National Provider Identifier is 1376701193, issued on May 29, 2008. The primary taxonomy on file is Mental Health Clinic/Center (Including Community Mental Health Center) (261QM0801X), and the practice location is in Baltimore, MD. The record was last updated on May 3, 2024.