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General NPI Number Information
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NPI Number | 1255765640
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Entity Type | Organization
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Legal Business Name | NORTH HARFORD COUNSELING, LLC
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Dates
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Enumeration Date | 08/21/2013
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Last Update Date | 09/17/2013
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Provider Practice Location Address
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Address Line | 1714 JARRETTSVILLE RD
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City | JARRETTSVILLE
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State | MD
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Zip | 21084-1524
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Country | US
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Telephone | 443-613-6233
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 183
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City | JARRETTSVILLE
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State | MD
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Zip | 21084-0183
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Country | US
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Telephone | 443-613-6233
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Fax |
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | MS. IDA MARE HENDERSON SIMA
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Credential | LCSW-C
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Telephone | 443-613-6233
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 11563
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License Number State | MD
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