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General NPI Number Information
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NPI Number | 1497972764
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Entity Type | Organization
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Legal Business Name | PROGRESSIVE COUNSELING AND TREATMENT SERVICE, INC.
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Dates
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Enumeration Date | 04/19/2007
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Last Update Date | 11/12/2015
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Provider Practice Location Address
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Address Line | 266 E MAIN ST
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City | WESTMINSTER
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State | MD
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Zip | 21157-5528
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Country | US
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Telephone | 410-848-7848
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Fax | 410-857-5172
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Provider Business Mailing Address
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Address Line | 75 W GREEN ST
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City | WESTMINSTER
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State | MD
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Zip | 21157-4439
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Country | US
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Telephone | 410-848-7848
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Fax | 410-857-5172
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Authorized Official
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Title or Position | CLINICAL THERAPIST
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Name | MS. JOAN MARIE MCINERNEY
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Credential | LSCW-C
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Telephone | 410-848-7848
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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 | 693726
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License Number State | MD
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