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General NPI Number Information
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NPI Number | 1457814246
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Entity Type | Organization
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Legal Business Name | SUMMIT COUNSELING SERVICES. LLC
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Dates
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Enumeration Date | 04/09/2019
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Last Update Date | 04/09/2019
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Provider Practice Location Address
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Address Line | 2671 MATTAWOMAN BEANTOWN RD
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City | WALDORF
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State | MD
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Zip | 20601-2340
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Country | US
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Telephone | 240-441-8095
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Fax | 301-710-0175
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Provider Business Mailing Address
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Address Line | 8834 COTTONGRASS ST
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City | WALDORF
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State | MD
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Zip | 20603-4943
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Country | US
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Telephone | 240-441-8095
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Fax | 301-710-0175
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | MS. ELINOR DICKSHINSKI
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Credential | LCPC
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Telephone | 240-441-8095
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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 |
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License Number State |
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