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BROOK LANE BEHAVIORAL SERVICES, INC.
NPI 1063721512
Clinic/Center - Mental Health (Including Community Mental Health Center) in Frederick, MD

Active since October 01, 2010
4540 MACK AVE STE B, FREDERICK, MD 21703(301) 733-0330(301) 733-4038 Get Directions Write a Review

NPPES record last updated: September 23, 2025. Verified against the NPPES registry weekly; last sync: September 20, 2026.

Record update history: Oct 1, 2018, Nov 25, 2015 (2 updates tracked since 2015).

About Brook Lane Behavioral Services, Inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BROOK LANE BEHAVIORAL SERVICES, INC. (NPI 1063721512) is a healthcare organization registered as a mental health (including community mental health center) in Frederick, Maryland and active in the NPI registry since October 2010. The organization lists Joshua Repac, Cfo, as its authorized official.

NPPES Registry Identity

NPI1063721512
Entity TypeOrganization
Primary Taxonomy261QM0801X
Legal Business NameBROOK LANE BEHAVIORAL SERVICES, INC.
Location Address4540 MACK AVE STE BFrederick, MD 21703-3303
Mailing Address4540 Mack Ave Ste BFrederick, MD 21703-3303 · (301) 733-0330 · Fax (301) 733-4038
Phone(301) 733-0330
Fax(301) 733-4038
Organization SubpartNo
Authorized OfficialJoshua RepacCfo · (301) 790-9351
Enumeration DateOctober 1, 2010
Last NPPES UpdateSeptember 23, 20252 updates tracked since enumeration
NPPES CertifiedSeptember 23, 2025
✔ NPI 1063721512 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Mental Health (Including Community Mental Health Center)Ambulatory Health Care Facilities
Taxonomy Code261QM0801X
4540 MACK AVE STE B, Frederick, MD 21703
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Other Names 1

Other NameBrook Lane Buckeystown

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ANGELA DUMITRACHE M.D.
Psychiatry & Neurology (Psychiatry)
4540 MACK AVE STE B
FREDERICK, MD 21703
Frederick County (301) 733-0331
ELIZABETH BRYANT
Counselor (Professional)
4540 MACK AVE STE B
FREDERICK, MD 21703
Frederick County (301) 733-0330
MELISSA CRIGGER NCC, LCPC
Counselor (Professional)
4540 MACK AVE STE B
FREDERICK, MD 21703
Frederick County (301) 733-0330
HEATHER MARIE PETRO LCPC
Counselor (Professional)
4540 MACK AVE STE B
FREDERICK, MD 21703
Frederick County (301) 733-0330
KENNETH SAAD LCPC
Counselor (Professional)
4540 MACK AVE STE B
FREDERICK, MD 21703
Frederick County (301) 733-0331
MR. CRESTON ZANE BAKER LCPC
Counselor (Professional)
4540 MACK AVE STE B
FREDERICK, MD 21703
Frederick County (301) 733-0330

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Brook Lane Behavioral Services, Inc.'s NPI number?

The NPI number for Brook Lane Behavioral Services, Inc. is 1063721512. It was assigned to this organization in the NPPES registry on October 1, 2010. The provider is also known as Brook Lane Buckeystown.

Where is Brook Lane Behavioral Services, Inc. located?

Brook Lane Behavioral Services, Inc. is located at 4540 Mack Ave Ste B, Frederick, MD 21703. The listed phone number is (301) 733-0330.

What is Brook Lane Behavioral Services, Inc.'s specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Mental Health (Including Community Mental Health Center), with taxonomy code 261QM0801X.

When was this NPI record last updated?

The NPPES record for Brook Lane Behavioral Services, Inc. was last updated on September 23, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.