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General NPI Number Information
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NPI Number | 1528919537
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Entity Type | Organization
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Legal Business Name | EVERGREEN COUNSELING AND WELLNESS
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Dates
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Enumeration Date | 02/05/2026
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Last Update Date | 02/05/2026
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Provider Practice Location Address
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Address Line | 3525 ELLICOTT MILLS DR STE G
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City | ELLICOTT CITY
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State | MD
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Zip | 21043-4638
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Country | US
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Telephone | 301-778-4431
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Fax |
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Provider Business Mailing Address
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Address Line | 5457 TWIN KNOLLS RD STE 300 #1496
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City | COLUMBIA
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State | MD
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Zip | 21045-3296
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Country | US
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Telephone | 301-778-4431
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Fax |
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | LAWRENCE RAKHMANOV
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Credential | LCPC
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Telephone | 301-778-4431
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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 |
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License Number State |
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