Healthcare Provider Details

I. General information

NPI: 1982104576
Provider Name (Legal Business Name): CAROL T HALLINAN LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/20/2018
Last Update Date: 02/15/2020
Certification Date: 02/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2205 YORK RD STE 200
TIMONIUM MD
21093-3167
US

IV. Provider business mailing address

421 SHERWOOD RD
COCKEYSVILLE MD
21030-2635
US

V. Phone/Fax

Practice location:
  • Phone: 410-916-6122
  • Fax:
Mailing address:
  • Phone: 410-916-6122
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLC10058
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: