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General NPI Number Information
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NPI Number | 1518413343
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Entity Type | Organization
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Legal Business Name | UNIVERSAL PROFESSIONAL COUNSELING
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Dates
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Enumeration Date | 08/31/2016
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Last Update Date | 08/31/2016
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Provider Practice Location Address
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Address Line | 6490 LANDOVER ROAD SUITE C ROOM 10
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City | CHEVERLY
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State | MD
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Zip | 20785
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Country | US
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Telephone | 301-322-7905
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Fax | 301-322-7906
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Provider Business Mailing Address
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Address Line | 1512 KINGSHILL ST
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City | BOWIE
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State | MD
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Zip | 20721-2035
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Country | US
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Telephone | 301-322-7905
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Fax |
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Authorized Official
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Title or Position | CLINICAL THERAPIST
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Name | MR. DARIUS DRISKELL
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Credential | MA
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Telephone | 301-322-7905
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LC1899
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License Number State | MD
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