Healthcare Provider Details

I. General information

NPI: 1518407931
Provider Name (Legal Business Name): ENSYNC COUNSELING & VOCATIONAL SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2017
Last Update Date: 03/03/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7912 MARFIELD PL APT. K
NOTTINGHAM MD
21236-3627
US

IV. Provider business mailing address

PO BOX 8440
PARKVILLE MD
21234-0440
US

V. Phone/Fax

Practice location:
  • Phone: 410-440-4789
  • Fax:
Mailing address:
  • Phone: 410-440-4789
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberLC2178
License Number StateMD

VIII. Authorized Official

Name: MS. PEARL OJIERE
Title or Position: THERAPIST
Credential: LCPC
Phone: 410-440-4789