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General NPI Number Information
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NPI Number | 1275712028
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Entity Type | Organization
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Legal Business Name | COLUMBIA MENTAL HEALTH RESOURCES, INC.
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Dates
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Enumeration Date | 10/29/2007
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Last Update Date | 11/05/2009
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Provider Practice Location Address
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Address Line | 10632 LITTLE PATUXENT PKWY SUITE 311
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City | COLUMBIA
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State | MD
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Zip | 21044-3273
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Country | US
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Telephone | 410-730-6950
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Fax | 410-730-1411
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Provider Business Mailing Address
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Address Line | 10632 LITTLE PATUXENT PKWY SUITE 311
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City | COLUMBIA
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State | MD
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Zip | 21044-3273
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Country | US
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Telephone | 410-730-6950
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Fax | 410-730-1411
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Authorized Official
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Title or Position | OWNER/DIRECTOR
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Name | DR. JANICE STEVENSON
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Credential | PHD
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Telephone | 410-730-6950
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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 | 02058
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License Number State | MD
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