Healthcare Provider Details

I. General information

NPI: 1225742166
Provider Name (Legal Business Name): EVA PECHIN LGPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/05/2023
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14927 OLD YORK RD
PHOENIX MD
21131-1435
US

IV. Provider business mailing address

14927 OLD YORK RD
PHOENIX MD
21131-1435
US

V. Phone/Fax

Practice location:
  • Phone: 443-798-1729
  • Fax:
Mailing address:
  • Phone: 443-798-1729
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLC15985
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: