Healthcare Provider Details

I. General information

NPI: 1912492653
Provider Name (Legal Business Name): BEHAVIORAL COUNSELING SERVICES OF WASHINGTON COUNTY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2018
Last Update Date: 06/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

427 E PATRICK ST
FREDERICK MD
21701-5777
US

IV. Provider business mailing address

124 E BALTIMORE ST
HAGERSTOWN MD
21740-6104
US

V. Phone/Fax

Practice location:
  • Phone: 301-662-7003
  • Fax:
Mailing address:
  • Phone: 301-739-7748
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: CHRISTINA TRENTON NEE
Title or Position: CHIEF OPERATING OFFICER
Credential: LCSW-C
Phone: 301-739-7748