Healthcare Provider Details

I. General information

NPI: 1497797021
Provider Name (Legal Business Name): FINKSBURG PLAZA COUNSELING SERVICE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2006
Last Update Date: 10/07/2022
Certification Date: 10/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1812 BALTIMORE BLVD SUITE C
WESTMINSTER MD
21157-7146
US

IV. Provider business mailing address

1812 BALTIMORE BLVD STE A
WESTMINSTER MD
21157-7144
US

V. Phone/Fax

Practice location:
  • Phone: 410-751-6176
  • Fax: 410-857-4176
Mailing address:
  • Phone: 410-751-6176
  • Fax: 410-857-4176

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateMD

VIII. Authorized Official

Name: MRS. PAMELA TREGOE MANNER
Title or Position: DIRECTOR
Credential: LCPC
Phone: 410-751-6176