Healthcare Provider Details

I. General information

NPI: 1477813822
Provider Name (Legal Business Name): CONTEMPLATIVE COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2012
Last Update Date: 01/26/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

304 W CHESAPEAKE AVE
TOWSON MD
21204-4405
US

IV. Provider business mailing address

713 HILLEN ROAD
TOWSON MD
21286-4405
US

V. Phone/Fax

Practice location:
  • Phone: 443-632-8814
  • Fax:
Mailing address:
  • Phone: 443-632-8814
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License NumberLC4446
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberLC4446
License Number StateMD

VIII. Authorized Official

Name: DAWN T LEWIS
Title or Position: PROFESSIONAL COUNSELOR
Credential: MS, LCPC, NCC
Phone: 443-632-8814