Healthcare Provider Details

I. General information

NPI: 1215525852
Provider Name (Legal Business Name): C&C ADVOCACY AND HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2021
Last Update Date: 07/16/2021
Certification Date: 07/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3655 OLD COURT RD STE 12
PIKESVILLE MD
21208-3905
US

IV. Provider business mailing address

3655 OLD COURT RD STE 12
PIKESVILLE MD
21208-3905
US

V. Phone/Fax

Practice location:
  • Phone: 443-929-1928
  • Fax: 410-800-2034
Mailing address:
  • Phone: 443-929-1928
  • Fax: 410-800-2034

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225C00000X
TaxonomyRehabilitation Counselor
License Number
License Number State

VIII. Authorized Official

Name: MR. CATHLYN CLARKE
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 443-929-1928