Healthcare Provider Details

I. General information

NPI: 1093400665
Provider Name (Legal Business Name): UNIDOS HEALING COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2023
Last Update Date: 01/03/2024
Certification Date: 01/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 MERCANTILE LN STE 244
LARGO MD
20774-5353
US

IV. Provider business mailing address

1400 MERCANTILE LN STE 244
LARGO MD
20774-5353
US

V. Phone/Fax

Practice location:
  • Phone: 301-346-7780
  • Fax:
Mailing address:
  • Phone: 301-346-7780
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: URSULA CAMELO-CERRO
Title or Position: OWNER/THERAPIST
Credential: LCPC, LPC
Phone: 301-346-7780