Provider Demographics
NPI:1023732906
Name:BLUEPRINT BEHAVIORAL HEALTH, LLC
Entity type:Organization
Organization Name:BLUEPRINT BEHAVIORAL HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PSYCHOTHERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:LANORA
Authorized Official - Middle Name:
Authorized Official - Last Name:DENNIS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-C
Authorized Official - Phone:240-278-7866
Mailing Address - Street 1:8209 MEADOWOOD DR
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:MD
Mailing Address - Zip Code:21076-1193
Mailing Address - Country:US
Mailing Address - Phone:240-278-7866
Mailing Address - Fax:
Practice Address - Street 1:8209 MEADOWOOD DR
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:MD
Practice Address - Zip Code:21076-1193
Practice Address - Country:US
Practice Address - Phone:240-278-7866
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-03
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)