Healthcare Provider Details

I. General information

NPI: 1932637055
Provider Name (Legal Business Name): TEN TEN COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2017
Last Update Date: 06/02/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17320 MOORE ROAD
BOYDS MD
20841
US

IV. Provider business mailing address

17320 MOORE ROAD
BOYDS MD
20841
US

V. Phone/Fax

Practice location:
  • Phone: 240-621-0836
  • Fax:
Mailing address:
  • Phone: 240-621-0836
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MR. LEONARD SMITH
Title or Position: OWNER/THERAPIST
Credential: LCPC
Phone: 240-621-0836