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General NPI Number Information
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NPI Number | 1316690712
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Entity Type | Organization
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Legal Business Name | CENTER FOR ACTUALIZED COUNSELING, LLC
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Dates
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Enumeration Date | 01/27/2022
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Last Update Date | 01/31/2022
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Provider Practice Location Address
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Address Line | 317 OVERBROOK RD
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City | BALTIMORE
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State | MD
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Zip | 21212-1802
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Country | US
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Telephone | 410-940-9329
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Fax |
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Provider Business Mailing Address
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Address Line | 31 OLD SOLOMONS ISLAND RD STE 201
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City | ANNAPOLIS
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State | MD
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Zip | 21401-3889
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Country | US
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Telephone | 410-618-1641
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Fax |
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Authorized Official
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Title or Position | OWNER/PRIMARY PSYCHOTHERAPIST
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Name | MR. BRADFORD CHRISTOPHER DREWNIAK
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Credential | LCPC
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Telephone | 410-618-1641
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | 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 | 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 #3
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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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