| Organization Name: | MENDELIS MENTAL HEALTH CENTER LLC |
| NPI Number: | 1053408377 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | PETER S MENDELIS (OWNER) |
| Mailing Address: | 11315 Pembrooke Sq Ste 112 Waldorf |
| State: | MD US |
| Postal Code: | 206034806 |
| Phone Number: | 3016385001 |
| Fax Number: | 3016385003 |
| NPI Enumeration Date: | 10/06/2006 |
| NPI Last Update Date: | 11/15/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 12909 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MD |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |