Provider Demographics
NPI:1689931594
Name:MNK REHABILITATION & PSYCHOLOGICAL SERVICES, INC.
Entity type:Organization
Organization Name:MNK REHABILITATION & PSYCHOLOGICAL SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDEN
Authorized Official - Prefix:DR
Authorized Official - First Name:MURUGI
Authorized Official - Middle Name:WA
Authorized Official - Last Name:MUNGAI-KAMAU
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:410-707-2396
Mailing Address - Street 1:2305 ELSINORE AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21216-2119
Mailing Address - Country:US
Mailing Address - Phone:410-707-2396
Mailing Address - Fax:410-884-2897
Practice Address - Street 1:2305 ELSINORE AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21216-2119
Practice Address - Country:US
Practice Address - Phone:410-707-2396
Practice Address - Fax:410-884-2897
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-16
Last Update Date:2012-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLCA1596101Y00000X, 101YA0400X, 101YM0800X, 101YP2500X
MD03103K00000X
MD03960103T00000X, 103TA0400X
MD04777103TA0700X, 103TC0700X, 103TC1900X, 103TC2200X, 103TF0000X, 103TP2701X, 106H00000X
MD0390103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
No103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)Group - Single Specialty
No103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & AgingGroup - Single Specialty
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Single Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Single Specialty
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamilyGroup - Single Specialty
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup PsychotherapyGroup - Single Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty