Healthcare Provider Details
I. General information
NPI: 1427823079
Provider Name (Legal Business Name): MC COUNSELING & TRAINING CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/22/2023
Last Update Date: 01/15/2025
Certification Date: 01/15/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
617 LAKEMONT DR
GLEN BURNIE MD
21060-8793
US
IV. Provider business mailing address
2657G ANNAPOLIS RD UNIT 404
HANOVER MD
21076-2467
US
V. Phone/Fax
- Phone: 443-292-2363
- Fax:
- Phone: 443-292-2363
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM0801X |
| Taxonomy | Mental Health Clinic/Center (Including Community Mental Health Center) |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM0850X |
| Taxonomy | Adult Mental Health Clinic/Center |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM0855X |
| Taxonomy | Adolescent and Children Mental Health Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MS.
RENEE
U.
MCLAUGHLIN
Title or Position: OWNER/THERAPIST
Credential: LCPC, NCC
Phone: 443-292-2363