1649906496 NPI number — ARUNDEL MENTAL HEALTH PROFESSIONALS LLC

Table of content: AMANDA MCCUNE ARRUDA DPT (NPI 1356867329)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649906496 NPI number — ARUNDEL MENTAL HEALTH PROFESSIONALS LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ARUNDEL MENTAL HEALTH PROFESSIONALS LLC
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:
Provider Other Organization Name Type Code:
6
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:
1649906496
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/28/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1511 RITCHIE HWY STE 202
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ARNOLD
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21012-2410
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-757-2077
Provider Business Mailing Address Fax Number:
410-757-5184

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
810 BESTGATE RD STE 325
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ANNAPOLIS
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21401-3648
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
443-906-3506
Provider Business Practice Location Address Fax Number:
443-782-2342
Provider Enumeration Date:
07/25/2022

Additional Information

Authorized Official

Authorized Official Last Name:
PARDO
Authorized Official First Name:
RYAN
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF LEGAL OFFICER
Authorized Official Telephone Number:
206-399-1493

Provider Taxonomy Codes

  • Taxonomy code: 103TC0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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