1467490151 NPI number — MARILYN YUNK LCSW-C

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467490151 NPI number — MARILYN YUNK LCSW-C

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

YUNK

Provider First Name:

MARILYN

Provider Middle Name:

Provider Name Prefix Text:

Provider Name Suffix Text:

Provider Credential Text:

LCSW-C

Provider Gender Code:

F

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number:

1467490151

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

06/07/2023

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

9165 RIVER HILL RD

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

LAUREL

Provider Business Mailing Address State Name:

MD

Provider Business Mailing Address Postal Code:

20723-1781

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

443-831-4145

Provider Business Mailing Address Fax Number:

410-366-8530

Provider First Line Business Practice Location Address:

10630 LITTLE PATUXENT PKWY

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:

COLUMBIA

Provider Business Practice Location Address State Name:

MD

Provider Business Practice Location Address Postal Code:

21044-3264

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

443-831-4145

Provider Business Practice Location Address Fax Number:

Provider Enumeration Date:

06/03/2006

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 1041C0700X , with the licence number:  02131 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 009612 . This is a "VALUEOPTIONS" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
• Identifier: 1821318-00 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
• Identifier: 397791 . This is a "TRICARE/MHN" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
• Identifier: 7562368 . This is a "AETNA BEHAVIORAL HEALTH" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
• Identifier: 258460 . This is a "KAISER" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
• Identifier: 257603 . This is a "COMPSYCH" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
• Identifier: 17281 . This is a "APS HEALTHCARE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
• Identifier: 232095000 . This is a "AMERIHEALTH" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
• Identifier: 281704 . This is a "MAMSI" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
• Identifier: 524452 . This is a "BCBS-MARYLAND" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
• Identifier: T541-0020 . This is a "CAREFIRST BCBS" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
• Identifier: 172517-000 . This is a "MAGELLEN" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".