Healthcare Provider Details

I. General information

NPI: 1891522074
Provider Name (Legal Business Name): CALEB ISZLER LGPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2024
Last Update Date: 09/19/2024
Certification Date: 09/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9301 ANNAPOLIS RD
LANHAM MD
20706-3115
US

IV. Provider business mailing address

6115 85TH PL
NEW CARROLLTON MD
20784-2843
US

V. Phone/Fax

Practice location:
  • Phone: 240-296-6300
  • Fax:
Mailing address:
  • Phone: 954-999-7424
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLGP15538
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: