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General NPI Number Information
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NPI Number | 1649723669
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Entity Type | Individual
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Provider Name | GERARD JANUSZEWSKI L.C.A.D.C.
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Gender | Male
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Dates
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Enumeration Date | 07/26/2016
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Last Update Date | 07/26/2016
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Provider Practice Location Address
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Address Line | 130 LUBRANO DR L-19
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City | ANNAPOLIS
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State | MD
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Zip | 21401-7038
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Country | US
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Telephone | 410-980-8957
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2184
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City | ANNAPOLIS
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State | MD
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Zip | 21404-2184
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Country | US
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Telephone | 410-980-8957
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | LCA365
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LCA365
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License Number State | MD
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