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General NPI Number Information
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NPI Number | 1134882202
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Entity Type | Individual
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Provider Name | MONICA DOUGLAS LGPC, NCC
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Gender | Female
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Dates
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Enumeration Date | 10/15/2021
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Last Update Date | 10/15/2021
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Provider Practice Location Address
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Address Line | 2255 CRAIN HWY STE 102
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City | WALDORF
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State | MD
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Zip | 20601-3186
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Country | US
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Telephone | 301-363-9122
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Fax |
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Provider Business Mailing Address
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Address Line | 1241 FARADAY PL NE
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City | WASHINGTON
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State | DC
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Zip | 20017-2815
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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 |
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Name |
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Credential |
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Telephone |
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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 | LGP12044
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License Number State | MD
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