Organization Name: | UNIVERSITY PSYCHOLOGICAL CENTER, INC. |
NPI Number: | 1417280488 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CLARK JOSEPH HUDAK (DIRECTOR/OWNER) |
Mailing Address: | 6201 Greenbelt Rd Suite U-18 Berwyn Heights |
State: | MD US |
Postal Code: | 207402354 |
Phone Number: | 3013451919 |
Fax Number: | 3013455779 |
NPI Enumeration Date: | 09/09/2009 |
NPI Last Update Date: | 09/09/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 903464 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MD |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |