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General NPI Number Information
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NPI Number | 1700437720
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Entity Type | Individual
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Provider Name | LORENA CHARMAINE SHIM CHOW MIN LCPC
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Gender | Female
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Dates
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Enumeration Date | 09/20/2019
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Last Update Date | 09/20/2019
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Provider Practice Location Address
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Address Line | 1407 LOCHNER RD STE 0
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City | BALTIMORE
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State | MD
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Zip | 21239-2932
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Country | US
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Telephone | 813-486-0602
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Fax |
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Provider Business Mailing Address
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Address Line | 219 MERLIN DR
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City | BELCAMP
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State | MD
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Zip | 21017-1539
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Country | US
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Telephone | 813-486-0602
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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 |
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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 | LC4382
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License Number State | MD
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