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General NPI Number Information
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NPI Number | 1003295676
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Entity Type | Organization
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Legal Business Name | DISCOVERY HARBOR COUNSELING CENTER LLC
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Dates
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Enumeration Date | 05/28/2015
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Last Update Date | 05/28/2015
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Provider Practice Location Address
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Address Line | 22776 THREE NOTCH RD SUITE #202
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City | LEXINGTON PARK
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State | MD
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Zip | 20653-3368
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Country | US
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Telephone | 301-862-9600
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Fax |
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Provider Business Mailing Address
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Address Line | 22776 THREE NOTCH RD SUITE #202
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City | LEXINGTON PARK
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State | MD
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Zip | 20653-3368
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Country | US
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Telephone | 301-862-9600
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Fax |
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Authorized Official
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Title or Position | LICENSED CLINICAL PROFESSIONAL COUN
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Name | URSULA TOWLES
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Credential | LCPC
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Telephone | 301-862-9600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LC5015
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License Number State | MD
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