Healthcare Provider Details

I. General information

NPI: 1740129527
Provider Name (Legal Business Name): ISAEIKA CARINA PALUCH LGPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/26/2026
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11785 BELTSVILLE DR STE 120
CALVERTON MD
20705-3121
US

IV. Provider business mailing address

362 EQUESTRIAN WAY
PRINCE FREDERICK MD
20678-3285
US

V. Phone/Fax

Practice location:
  • Phone: 240-389-1487
  • Fax:
Mailing address:
  • Phone: 775-386-5518
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLGP17662
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: