Healthcare Provider Details

I. General information

NPI: 1952815474
Provider Name (Legal Business Name): FLANAGAN COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2017
Last Update Date: 12/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 NEWBURG AVE STE 101
CATONSVILLE MD
21228-5168
US

IV. Provider business mailing address

9 NEWBURG AVE STE 101
CATONSVILLE MD
21228-5168
US

V. Phone/Fax

Practice location:
  • Phone: 215-253-9365
  • Fax:
Mailing address:
  • Phone: 215-253-9365
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number21727
License Number StateMD

VIII. Authorized Official

Name: SHANNON FLANAGAN
Title or Position: OWNER
Credential: LCSW-C
Phone: 215-253-9365