Healthcare Provider Details

I. General information

NPI: 1366052193
Provider Name (Legal Business Name): PSYCHOLOGICAL COUNSELING AND EDUCATIONAL SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2020
Last Update Date: 08/06/2020
Certification Date: 08/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4409 FORBES BLVD STE B
LANHAM MD
20706-4373
US

IV. Provider business mailing address

4409 FORBES BLVD STE B
LANHAM MD
20706-4373
US

V. Phone/Fax

Practice location:
  • Phone: 301-683-8833
  • Fax:
Mailing address:
  • Phone: 301-683-8833
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: DR. NATOSHA SPEIGHT
Title or Position: CLINICAL DIRECTOR
Credential: PH.D., LCSW-C
Phone: 301-683-8833