Healthcare Provider Details

I. General information

NPI: 1639074602
Provider Name (Legal Business Name): CHARLIE'S ANGEL COUNSELING & CONSULTING SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2026
Last Update Date: 10/10/2026
Certification Date: 10/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1005 E PATAPSCO AVE
BALTIMORE MD
21225-2228
US

IV. Provider business mailing address

1003 E PATAPSCO AVE
BALTIMORE MD
21225-2228
US

V. Phone/Fax

Practice location:
  • Phone: 443-831-0191
  • Fax: 410-355-2350
Mailing address:
  • Phone: 443-831-0191
  • Fax: 410-355-2350

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. PAMELA DUKES
Title or Position: CEO
Credential: LCPC
Phone: 443-831-0191