Healthcare Provider Details

I. General information

NPI: 1811086572
Provider Name (Legal Business Name): DPK COUNSELING & CONSULTING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 STEEPLE CHASE DRIVE SUITE 104
PRINCE FREDERICK MD
20678
US

IV. Provider business mailing address

301 STEEPLE CHASE DRIVE SUITE 104
PRINCE FREDERICK MD
20678
US

V. Phone/Fax

Practice location:
  • Phone: 410-535-4854
  • Fax: 410-535-6272
Mailing address:
  • Phone: 410-535-4854
  • Fax: 410-535-6272

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MRS. DEBORAH LEE PETRO-KREAHLING
Title or Position: PRESIDENT MSN APRN BC
Credential: CLINICAL NURSE SPECI
Phone: 410-535-4854