Healthcare Provider Details

I. General information

NPI: 1841883121
Provider Name (Legal Business Name): MINDY NAVARRO LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/17/2021
Last Update Date: 04/26/2023
Certification Date: 04/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8638 VETERANS HWY
MILLERSVILLE MD
21108-1422
US

IV. Provider business mailing address

7823 MALLOW CT
PASADENA MD
21122-6379
US

V. Phone/Fax

Practice location:
  • Phone: 240-813-3935
  • Fax:
Mailing address:
  • Phone: 240-813-3935
  • Fax: 410-360-1675

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLC11980
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLC11980
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: