MEDICARE: CENTREPOINTE COUNSELING, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP1600X	Pastoral Counselor

General Provider Information

NPI Number	:	1295116168
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTREPOINTE COUNSELING, INC.

Provider Business Mailing Address
First Line	:	17826 NEW HAMPSHIRE AVE
Second Line	:
City	:	ASHTON
State	:	MD
Zip	:	20861-9781
Country	:	US
Telephone Number	:	800-491-5369
Fax Number	:	301-774-3678

Provider Business Practice Location Address
First Line	:	6922 MUNCASTER MILL RD
Second Line	:
City	:	ROCKVILLE
State	:	MD
Zip	:	20855-1546
Country	:	US
Telephone Number	:	800-491-5369
Fax Number	:	301-774-3678

Authorized Official
Title or Position	:	CLINICAL DIRECTOR
Name	:	MATTHEW RAEDER
Credential	:	LCSW
Telephone Number	:	800-491-5369

Provider Enumeration Date	:	06/16/2015
Last Update Date	:	02/23/2022

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