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SOUTH RIVER PSYCHIATRY
NPI 1275382871
Psychiatry & Neurology - Psychiatry in Glen Burnie, MD

Active since May 15, 2024
1600 CRAIN HWY S STE 608, GLEN BURNIE, MD 21061(410) 205-9205(619) 268-5973 Get Directions Write a Review

NPPES record last updated: May 15, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About South River Psychiatry NPPES

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

SOUTH RIVER PSYCHIATRY (NPI 1275382871) is a healthcare organization registered as a psychiatry in Glen Burnie, Maryland and active in the NPI registry since May 2024. The organization lists Donna Lorraine Ticknor, Owner/physician, as its authorized official.

NPPES Registry Identity

NPI1275382871
Entity TypeOrganization
Primary Taxonomy2084P0800X
Legal Business NameSOUTH RIVER PSYCHIATRIC SERVICES, LLC
Location Address1600 CRAIN HWY S STE 608Glen Burnie, MD 21061-6442
Mailing Address408 Kathe CtRiva, MD 21140-1312 · (410) 205-9205 · Fax (619) 268-5973
Phone(410) 205-9205
Fax(619) 268-5973
Organization SubpartNo
Authorized OfficialDonna Lorraine TicknorOwner/physician · (410) 205-9205
Enumeration DateMay 15, 2024
NPPES CertifiedMay 15, 2024
✔ NPI 1275382871 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0800X
Definition
A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.
1600 CRAIN HWY S STE 608, Glen Burnie, MD 21061
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Other Names 1

Doing Business AsSouth River Psychiatry

Other Identifiers 2

Other1720131295Individual Npi
OtherD0086372MD · State Medical License

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 5

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

LINDSEY WEST LCSW
Social Worker (Clinical)
1600 CRAIN HWY S STE 608
GLEN BURNIE, MD 21061
Anne Arundel County (443) 354-1200
KARAN KAPOOR LMSW
Social Worker
1600 CRAIN HWY S STE 608
GLEN BURNIE, MD 21061
Anne Arundel County (443) 354-1200
GILA CHAMAMA LGPC
Psychologist (Counseling)
1600 CRAIN HWY S STE 608
GLEN BURNIE, MD 21061
Anne Arundel County (443) 354-1200
DR. DONNA LORRAINE TICKNOR M.D.
Psychiatry & Neurology (Psychiatry)
1600 CRAIN HWY S STE 608
GLEN BURNIE, MD 21061
Anne Arundel County (410) 205-9205
AVIGAYIL RABI LCSW
Social Worker
1600 CRAIN HWY S STE 608
GLEN BURNIE, MD 21061
Anne Arundel County (443) 354-1200

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 South River Psychiatric Services, LLC's NPI number?

The NPI number for South River Psychiatric Services, LLC is 1275382871. It was assigned to this organization in the NPPES registry on May 15, 2024. The provider is doing business as South River Psychiatry.

Where is South River Psychiatric Services, LLC located?

South River Psychiatric Services, LLC is located at 1600 Crain Hwy S Ste 608, Glen Burnie, MD 21061. The listed phone number is (410) 205-9205.

What is South River Psychiatric Services, LLC's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

When was this NPI record last updated?

The NPPES record for South River Psychiatric Services, LLC was last updated on May 15, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.