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General NPI Number Information
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NPI Number | 1760871479
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Entity Type | Organization
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Legal Business Name | EVEREST HEALTH COUNSEL, LLC
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Dates
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Enumeration Date | 01/19/2015
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Last Update Date | 06/01/2016
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Provider Practice Location Address
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Address Line | 704 LENNOX ST
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City | BALTIMORE
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State | MD
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Zip | 21217-4606
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Country | US
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Telephone | 202-415-3363
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Fax |
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Provider Business Mailing Address
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Address Line | 704 LENNOX ST
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City | BALTIMORE
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State | MD
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Zip | 21217-4606
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Country | US
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Telephone |
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Fax | 410-834-5479
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | DOLORES MUTUKU
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Credential |
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Telephone | 202-415-3363
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State | MD
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