National Provider Identifier

Pudds Place

Pudds Place is listed in the NPPES registry with a primary specialty of Addiction (Substance Use Disorder) Counselor in Baltimore, MD and a listed phone number of (443) 633-3177.

NPI 1619694239Baltimore, MDAddiction (Substance Use Disorder) Counselor

Source: public NPPES record, last updated October 25, 2022. This profile is informational and is not medical advice, a quality rating, or a provider recommendation.

Profile Overview

NPI
1619694239
Provider Type
Organization
Primary Specialty
Addiction (Substance Use Disorder) Counselor
Enumeration Date
October 25, 2022
Last Updated
October 25, 2022

Practice Location

  • 2413 Reisterstown RD Apt 1
  • Baltimore, MD 21217-2056

Phone: (443) 633-3177

Mailing Address

  • 3018 Autumn Branch Ln Apt E
  • Ellicott City, MD 21043-3514

Authorized Official

Name
Sykia Edwards
Title
Clinical Director
Credentials
CAC-AD-BAS, LMSW
Phone
(443) 633-3177

Specialties

  • Addiction (Substance Use Disorder) Counselor (101YA0400X)

Endpoints

  • www.puddsplace.com

    Connect Url | Direct | Csv | Baltimore, MD 21217

    Website

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Full Record
NPI
1619694239
Entity Type
Organization
EIN
<UNAVAIL>
Organization Name
Pudds Place
Mailing Street Address
3018 Autumn Branch Ln Apt E
Mailing City
Ellicott City
Mailing State
MD
Mailing ZIP Code
21043-3514
Mailing Country
US
Mailing Phone
(443) 633-3177
Practice Street Address
2413 Reisterstown RD Apt 1
Practice City
Baltimore
Practice State
MD
Practice ZIP Code
21217-2056
Practice Country
US
Practice Phone
(443) 633-3177
Enumeration Date
October 25, 2022
Last Updated
October 25, 2022
Authorized Official Last Name
Edwards
Authorized Official First Name
Sykia
Authorized Official Title
Clinical Director
Authorized Official Phone
(443) 633-3177
Organization Subpart
No
Authorized Official Credential Text
CAC-AD-BAS, LMSW
Taxonomy Group 1
193200000X Multi-Specialty Group
Certification Date
October 25, 2022
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Addiction (Substance Use Disorder) Counselor (101YA0400X)
Other Identifiers
1093103756 (MD)