Healthcare Provider Details

I. General information

NPI: 1275378572
Provider Name (Legal Business Name): ALEX P RENNICH LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/27/2024
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10400 LITTLE PATUXENT PKWY STE 305
COLUMBIA MD
21044-3518
US

IV. Provider business mailing address

10400 LITTLE PATUXENT PKWY STE 305
COLUMBIA MD
21044-3518
US

V. Phone/Fax

Practice location:
  • Phone: 410-210-4098
  • Fax: 240-614-2133
Mailing address:
  • Phone: 410-210-4098
  • Fax: 240-614-2133

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLC18128
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: