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UNIVERSITY PSYCHOLOGICAL CENTER, INC.

Addiction Substance Use Disorder

Baltimore, Maryland

Provider NPI: 1962432724

Organization Information:
Organization Name:  UNIVERSITY PSYCHOLOGICAL CENTER, INC.
Organization is not Subpart
Authorized Official:  CLARK JOSEPH HUDAK  PRESIDENT/OWNER  410-5769191

Practice Location:
201 N CHARLES ST SUITE 200 BALTIMORE, MD 21201 US
Tel: 410-576-9191  Fax: 410-576-9257

Business Mailing Address:
201 N CHARLES ST SUITE 200 BALTIMORE, MD 21201 US
Tel: 410-576-9191  Fax: 410-576-9257

Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N101YA0400XBehavioral Health & Social Service Providers
Counselor
Addiction (Substance Use Disorder)
Y101YM0800XBehavioral Health & Social Service Providers
Counselor
N103T00000XBehavioral Health & Social Service Providers
Psychologist
N1041C0700XBehavioral Health & Social Service Providers
Social Worker
N2084P0800XPhysicians
Psychiatry & Neurology

Other Provider Identifiers:

IssuerNumberStateType
094981710MD05
023002200MD05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







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