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General NPI Number Information
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NPI Number | 1225274137
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Entity Type | Organization
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Legal Business Name | SUGARLOAF COUNSELING & PSYCHOTHERAPY ASSOCIATES
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Dates
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Enumeration Date | 12/23/2008
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Last Update Date | 12/23/2008
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Provider Practice Location Address
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Address Line | 18 EXECUTIVE PARK CT
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City | GERMANTOWN
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State | MD
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Zip | 20874-2645
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Country | US
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Telephone | 301-428-3557
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Fax | 301-972-6635
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Provider Business Mailing Address
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Address Line | 18 EXECUTIVE PARK CT
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City | GERMANTOWN
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State | MD
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Zip | 20874-2645
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Country | US
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Telephone | 301-428-3557
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Fax | 301-972-6635
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. MICHAEL L ABRAHAMS
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Credential | LCSW-C
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Telephone | 301-428-3557
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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 | LC2107
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License Number State | MD
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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 | 12918
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 2843
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License Number State | MD
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