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General NPI Number Information
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NPI Number | 1477612984
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Entity Type | Organization
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Legal Business Name | YOUR NEW DIRECTION LLC
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Dates
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Enumeration Date | 12/08/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 204 CENTER ST
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City | MOUNT AIRY
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State | MD
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Zip | 21771-5444
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Country | US
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Telephone | 301-607-8777
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Fax |
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Provider Business Mailing Address
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Address Line | 1884 LAKELAND DR
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City | FINKSBURG
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State | MD
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Zip | 21048-2622
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Country | US
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Telephone | 410-833-9095
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | MS. ANNA ROYS
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Credential | LCSW-C
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Telephone | 301-607-8777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 10175
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License Number State | MD
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