Healthcare Provider Details

I. General information

NPI: 1811067663
Provider Name (Legal Business Name): MONOCACY COUNSELING CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2006
Last Update Date: 06/04/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1207 NORTH EAST ST.
FREDERICK MD
21701
US

IV. Provider business mailing address

1207 NORTH EAST ST.
FREDERICK MD
21701
US

V. Phone/Fax

Practice location:
  • Phone: 301-846-0967
  • Fax: 301-846-0443
Mailing address:
  • Phone: 301-846-0967
  • Fax: 301-846-0443

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name: MS. BARBARA L. HARRINGTON
Title or Position: BUSINESS MGR.
Credential:
Phone: 301-846-0967