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General NPI Number Information
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NPI Number | 1063957900
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Entity Type | Organization
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Legal Business Name | LC COUNSELING
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Dates
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Enumeration Date | 01/02/2017
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Last Update Date | 01/02/2017
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Provider Practice Location Address
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Address Line | 360 MAIN ST
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City | REISTERSTOWN
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State | MD
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Zip | 21136-1919
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Country | US
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Telephone | 410-526-5387
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Fax |
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Provider Business Mailing Address
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Address Line | 10506 WILLOW VISTA WAY
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City | COCKEYSVILLE
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State | MD
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Zip | 21030-1038
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Country | US
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Telephone | 410-404-8661
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ANNETTE RICKERT CALLAHAN
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Credential | LCSW-C
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Telephone | 410-404-8661
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 10971
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License Number State | MD
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