Healthcare Provider Details

I. General information

NPI: 1780450072
Provider Name (Legal Business Name): CLOVER HILL COUNSELING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2023
Last Update Date: 11/28/2023
Certification Date: 11/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

812 TOLL HOUSE AVE
FREDERICK MD
21701-4519
US

IV. Provider business mailing address

8167 HUNTER TRAIL CT
FREDERICK MD
21702-2928
US

V. Phone/Fax

Practice location:
  • Phone: 240-499-4694
  • Fax:
Mailing address:
  • Phone: 240-499-4694
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DAVID SNIPES
Title or Position: THERAPIST
Credential: LGPC
Phone: 240-499-4694