South River Psychiatry
LBN: South River Psychiatric Services, Llc
South River Psychiatry is an health care organization with primary practice located at 1600 Crain Hwy S Ste 608 , Glen Burnie MD 21061-6442. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as the primary health care specialty.
South River Psychiatric Services, Llc can be contacted via phone (410) 205-9205, or through Ticknor, Donna Lorraine via phone (410) 205-9205.
Contact Information
Primary practice address
1600 Crain Hwy S Ste 608
Glen Burnie MD 21061-6442
Phone: (410) 205-9205
Fax: (619) 268-5973
Website:
Authorized official contact:
Name: Ticknor, Donna Lorraine Doctor of Medicine (MD)
Phone: (410) 205-9205
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X |
Profile Details
NPI number | 1275382871 |
---|---|
LBN Legal business name | South River Psychiatric Services, Llc |
DBA Doing business as | South River Psychiatry |
Authorized official | Ticknor, Donna Lorraine Doctor of Medicine (MD) |
Entity | Organization |
Organization subpart 1 | No |
Enumeration date | May 15th, 2024 |
Last updated | May 15th, 2024 - about 7 months ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1275382871 | NPPES |
Other | 1720131295 | INDIVIDUAL NPI | |
Other | D0086372 | INDIVIDUAL NPI |
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