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General NPI Number Information
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NPI Number | 1215744610
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Entity Type | Organization
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Legal Business Name | CONGRUENT COUNSELING SERVICES, LLC
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Dates
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Enumeration Date | 12/18/2024
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Last Update Date | 12/18/2024
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Provider Practice Location Address
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Address Line | 100 N DIVISION ST
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City | SALISBURY
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State | MD
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Zip | 21801-5039
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Country | US
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Telephone | 410-740-8066
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Fax | 410-740-8068
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Provider Business Mailing Address
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Address Line | 10630 LITTLE PATUXENT PKWY STE 209
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City | COLUMBIA
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State | MD
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Zip | 21044-6278
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Country | US
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Telephone | 410-740-8066
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Fax | 410-740-8068
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Authorized Official
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Title or Position | LCADC
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Name | MARK DAVID DONOVAN
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Credential | LCPC
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Telephone | 410-740-8066
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health 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 | 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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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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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 | 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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