Healthcare Provider Details

I. General information

NPI: 1447634498
Provider Name (Legal Business Name): OIC COUNSELING SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2015
Last Update Date: 07/18/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

336 S MAIN ST SUITE 1C
BEL AIR MD
21014-3978
US

IV. Provider business mailing address

336 S MAIN ST SUITE 1C
BEL AIR MD
21014-3978
US

V. Phone/Fax

Practice location:
  • Phone: 410-836-0820
  • Fax: 443-403-0734
Mailing address:
  • Phone: 410-836-0820
  • Fax: 443-403-0734

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MR. ERRIC HETZER
Title or Position: OWNER
Credential: LCSW-C
Phone: 410-459-3441