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General NPI Number Information
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NPI Number | 1235517269
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Entity Type | Organization
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Legal Business Name | GREATER ALLEGANY COUNSELING
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Dates
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Enumeration Date | 05/11/2015
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Last Update Date | 05/11/2015
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Provider Practice Location Address
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Address Line | 1007 FREDERICK RD
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City | CATONSVILLE
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State | MD
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Zip | 21228-5038
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Country | US
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Telephone | 443-341-6736
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Fax | 410-630-3600
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Provider Business Mailing Address
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Address Line | 1007 FREDERICK RD
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City | CATONSVILLE
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State | MD
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Zip | 21228-5038
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Country | US
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Telephone | 443-341-6736
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Fax | 410-630-3600
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Authorized Official
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Title or Position | OWNER
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Name | MS. JANE CONNELL
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Credential | MS, LCPC
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Telephone | 301-268-6225
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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 | LC2197
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License Number State | MD
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