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General NPI Number Information
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NPI Number | 1497134167
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Entity Type | Organization
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Legal Business Name | NEW REFLECTIONS THERAPEUTIC SERVICES
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Dates
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Enumeration Date | 05/27/2015
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Last Update Date | 05/27/2015
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Provider Practice Location Address
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Address Line | 5020 SUNNYSIDE AVE SUITE 112
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City | BELTSVILLE
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State | MD
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Zip | 20705-2307
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Country | US
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Telephone | 240-297-9143
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 717
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City | BELTSVILLE
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State | MD
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Zip | 20704-0717
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Country | US
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Telephone | 240-297-9143
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Fax |
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Authorized Official
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Title or Position | OWNER/ LICENSED CLINICAL COUNSELOR
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Name | MISS KARIMAH CORNELIUS
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Credential |
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Telephone | 240-297-9143
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LC3612
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License Number State | MD
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