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General NPI Number Information
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NPI Number | 1780977496
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Entity Type | Organization
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Legal Business Name | COUNSELINGWORKS LLC
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Dates
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Enumeration Date | 05/27/2011
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Last Update Date | 12/05/2011
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Provider Practice Location Address
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Address Line | 5310 OLD COURT RD SUITE 308
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City | RANDALLSTOWN
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State | MD
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Zip | 21133-5243
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Country | US
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Telephone | 443-863-6699
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Fax | 443-863-6635
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Provider Business Mailing Address
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Address Line | 4021 WINLEE RD
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City | RANDALLSTOWN
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State | MD
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Zip | 21133-4034
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Country | US
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Telephone | 443-863-6699
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Fax |
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Authorized Official
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Title or Position | CLINICAL SOCIAL WORKER
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Name | MONICA WASHINGTON
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Credential | LCSW-C
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Telephone | 443-863-6699
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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 | 11005
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License Number State | MD
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