Healthcare Provider Details

I. General information

NPI: 1407761083
Provider Name (Legal Business Name): ASIA PROCTOR LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

713 HARRY S TRUMAN DR APT 407
LARGO MD
20774-2089
US

IV. Provider business mailing address

713 HARRY S TRUMAN DR APT 407
LARGO MD
20774-2089
US

V. Phone/Fax

Practice location:
  • Phone: 240-501-0990
  • Fax: 240-501-0990
Mailing address:
  • Phone: 240-501-0990
  • Fax: 240-501-0990

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberPRC200002064
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: