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General NPI Number Information
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NPI Number | 1780066175
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Entity Type | Organization
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Legal Business Name | BALTIMORE WASHINGTON COUNSELING CENTER, LLC
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Dates
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Enumeration Date | 06/23/2015
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Last Update Date | 09/18/2015
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Provider Practice Location Address
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Address Line | 8258 VETERANS HWY SUITE 13
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City | MILLERSVILLE
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State | MD
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Zip | 21108-1457
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Country | US
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Telephone | 410-768-6088
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Fax | 410-768-6444
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Provider Business Mailing Address
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Address Line | 8258 VETERANS HWY SUITE 13
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City | MILLERSVILLE
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State | MD
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Zip | 21108-1457
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Country | US
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Telephone | 410-768-6088
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Fax | 410-768-6444
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | CHRISTINE RYKIEL
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Credential | LCSW-C
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Telephone | 410-768-6088
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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 | 09540
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License Number State | MD
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