Healthcare Provider Details

I. General information

NPI: 1174956965
Provider Name (Legal Business Name): LINGANORE COUNSELING AND WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2013
Last Update Date: 06/06/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

164 W MAIN ST SUITE A
NEW MARKET MD
21774-6279
US

IV. Provider business mailing address

11670 OLD NATIONAL PIKE 103
NEW MARKET MD
21774-6123
US

V. Phone/Fax

Practice location:
  • Phone: 301-865-2226
  • Fax: 301-865-6720
Mailing address:
  • Phone: 301-865-2226
  • Fax: 301-865-6720

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MRS. MARY HOLZINGER
Title or Position: OWNER
Credential: LCSW-C, CEAP
Phone: 301-865-2226