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General NPI Number Information
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NPI Number | 1104547330
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Entity Type | Organization
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Legal Business Name | LIVING WELL AND WHOLE COUNSELING SERVICES
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Dates
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Enumeration Date | 09/06/2022
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Last Update Date | 03/18/2024
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Provider Practice Location Address
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Address Line | 9711 WASHINGTONIAN BLVD STE 550
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City | GAITHERSBURG
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State | MD
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Zip | 20878-5789
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Country | US
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Telephone | 443-507-8467
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Fax |
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Provider Business Mailing Address
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Address Line | 9711 WASHINGTONIAN BLVD STE 550
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City | GAITHERSBURG
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State | MD
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Zip | 20878-5789
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | JENNIFER MARQUEZ
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Credential | LCSW-C
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Telephone | 301-758-7487
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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 |
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License Number State |
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