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General NPI Number Information
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NPI Number | 1609160126
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Entity Type | Organization
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Legal Business Name | HARBOR COUNSELING LLC
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Dates
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Enumeration Date | 06/01/2011
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Last Update Date | 06/01/2011
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Provider Practice Location Address
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Address Line | 5710 NEWBURY ST 2ND FLOOR
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City | BALTIMORE
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State | MD
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Zip | 21209-3657
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Country | US
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Telephone | 443-501-4094
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Fax |
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Provider Business Mailing Address
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Address Line | 1435 BOYLE ST
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City | BALTIMORE
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State | MD
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Zip | 21230-5112
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Country | US
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Telephone | 443-468-8834
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Fax |
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Authorized Official
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Title or Position | OWNER/ PRESIDENT
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Name | MR. JAMIE METZLER
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Credential |
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Telephone | 443-468-8834
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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 | 14659
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License Number State | MD
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