Healthcare Provider Details

I. General information

NPI: 1134968472
Provider Name (Legal Business Name): WIZEMAN COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2024
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1910 TOWNE CENTRE BLVD
ANNAPOLIS MD
21401-3598
US

IV. Provider business mailing address

1910 TOWNE CENTRE BLVD
ANNAPOLIS MD
21401-3598
US

V. Phone/Fax

Practice location:
  • Phone: 443-732-0778
  • Fax:
Mailing address:
  • Phone: 443-732-0778
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: DANA SKOLNICK WIZEMAN
Title or Position: MENTAL HEALTH CLINICIAN
Credential: LPC
Phone: 443-732-0778