Healthcare Provider Details

I. General information

NPI: 1811766421
Provider Name (Legal Business Name): COUNSELING CONSTRUCTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/22/2023
Last Update Date: 12/22/2023
Certification Date: 12/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

815 RITCHIE HWY STE 210
SEVERNA PARK MD
21146-4164
US

IV. Provider business mailing address

7615 WEATHER WORN WAY UNIT A
COLUMBIA MD
21046-1490
US

V. Phone/Fax

Practice location:
  • Phone: 443-472-1048
  • Fax:
Mailing address:
  • Phone: 443-472-1048
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BARBARA J BORSI
Title or Position: THERAPIST
Credential: LCPC
Phone: 443-472-1048