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General NPI Number Information
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NPI Number | 1114673654
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Entity Type | Organization
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Legal Business Name | ARUNDEL PSYCHOLOGICAL ASSOCIATES LLC
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Dates
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Enumeration Date | 02/23/2022
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Last Update Date | 02/23/2022
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Provider Practice Location Address
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Address Line | 1110 BENFIELD BLVD STE J
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City | MILLERSVILLE
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State | MD
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Zip | 21108-2645
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Country | US
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Telephone | 410-987-2031
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Fax |
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Provider Business Mailing Address
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Address Line | 2 KAGEE CT
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City | SEVERNA PARK
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State | MD
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Zip | 21146-4829
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Country | US
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Telephone | 443-904-4429
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Fax |
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | LISA MARIE GRANT
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Credential | MS NCSP
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Telephone | 443-904-4429
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State |
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