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General NPI Number Information
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NPI Number | 1679974562
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Entity Type | Organization
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Legal Business Name | PROMISE COUNSELING SERVICES LLC
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Dates
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Enumeration Date | 09/10/2014
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Last Update Date | 09/10/2014
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Provider Practice Location Address
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Address Line | 3415 FALLSTAFF RD
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City | BALTIMORE
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State | MD
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Zip | 21215-1724
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Country | US
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Telephone | 410-764-6965
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Fax |
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Provider Business Mailing Address
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Address Line | 3415 FALLSTAFF RD
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City | BALTIMORE
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State | MD
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Zip | 21215-1724
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Country | US
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Telephone | 410-764-6965
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | DR. VENUS RW STEWART
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Credential | PHD, CAGS, LCPC
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Telephone | 410-764-6965
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LC4388
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License Number State | MD
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