Healthcare Provider Details

I. General information

NPI: 1639036668
Provider Name (Legal Business Name): AFFECTIVE THERAPEUTIC SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2026
Last Update Date: 01/09/2026
Certification Date: 01/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1329 CROFTON RD
BALTIMORE MD
21239-3934
US

IV. Provider business mailing address

1329 CROFTON RD
BALTIMORE MD
21239-3934
US

V. Phone/Fax

Practice location:
  • Phone: 410-999-1434
  • Fax:
Mailing address:
  • Phone: 410-999-1434
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MS. VERONICA DENISE EDWARDS
Title or Position: MENTAL HEALTH COUNSELOR
Credential: LCPC
Phone: 443-527-1368