1134186638 NPI number — EM BARTLINSKI & ASSOCIATES

Table of content: (NPI 1134186638)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134186638 NPI number — EM BARTLINSKI & ASSOCIATES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
EM BARTLINSKI & ASSOCIATES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
ASSOCIATED PSYCHOTHERAPISTS OF MD & ADEPT
Provider Other Organization Name Type Code:
3
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 Information

NPI Number:
1134186638
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/30/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
CRAIN STATION 5 CRAIN HWY
Provider Second Line Business Mailing Address:
2ND FLOOR
Provider Business Mailing Address City Name:
GLEN BURNIE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21061-2803
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-761-0725
Provider Business Mailing Address Fax Number:
410-761-2412

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5 CRAIN HWY N, 2ND FLOOR
Provider Second Line Business Practice Location Address:
CRAIN STATION
Provider Business Practice Location Address City Name:
GLEN BURNIE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21061-2803
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-761-0725
Provider Business Practice Location Address Fax Number:
410-761-2412
Provider Enumeration Date:
04/27/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BARTLINSKI
Authorized Official First Name:
EUGENE
Authorized Official Middle Name:
MICHAEL
Authorized Official Title or Position:
OWNER/PROGRAM DIRECTOR
Authorized Official Telephone Number:
410-761-0725

Provider Taxonomy Codes

  • Taxonomy code: 101Y00000X , with the licence number:  LC2002 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YA0400X , with the licence number: LCA134 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YA0400X , with the licence number: SC2109 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YA0400X , with the licence number: LC1371 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YA0400X , with the licence number: LC4453 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YM0800X , with the licence number: LC1371 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 104100000X , with the licence number: 11957 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 104100000X , with the licence number: 03285 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 104100000X , with the licence number: 11975 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 133131100 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: M0830000 . This is a "CAREFIRST" identifier . This identifiers is of the category "OTHER".




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