Healthcare Provider Details

I. General information

NPI: 1568719631
Provider Name (Legal Business Name): PEOPLES CHOICE COUNSELING AND HEALTH SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2012
Last Update Date: 08/08/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13201 TANEY DR
BELTSVILLE MD
20705-3254
US

IV. Provider business mailing address

7305 BALTIMORE AVE SUITE@103
COLLEGE PARK MD
20740-3234
US

V. Phone/Fax

Practice location:
  • Phone: 301-503-6623
  • Fax: 301-969-1459
Mailing address:
  • Phone: 301-969-1458
  • Fax: 301-969-1459

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License NumberD14745079
License Number StateMD

VIII. Authorized Official

Name: MR. BINU ABRAHAM
Title or Position: CLINICAL SOCIAL WORKER/THERAPIST
Credential: MSW, LICSW, LCSW-C
Phone: 301-503-6623