Healthcare Provider Details

I. General information

NPI: 1497166904
Provider Name (Legal Business Name): WASHINGTON COUNSELING SERVICE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2014
Last Update Date: 05/19/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 SUDBROOK LN
TOWSON MD
21208-4117
US

IV. Provider business mailing address

PO BOX 9703
TOWSON MD
21284-9703
US

V. Phone/Fax

Practice location:
  • Phone: 410-484-8560
  • Fax: 410-484-8561
Mailing address:
  • Phone: 410-484-8560
  • Fax: 410-484-8561

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberLC5190
License Number StateMD

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: LINDA D WASHINGTON
Title or Position: OWNER
Credential: LCPC
Phone: 410-484-8560