=====================================================
General NPI Number Information
=====================================================
NPI Number | 1790080885
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | APRIL KRIZ LCPC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/20/2011
-----------------------------------------------------
Last Update Date | 07/23/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 28105 THREE NOTCH RD
-----------------------------------------------------
City | MECHANICSVILLE
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20659-3235
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 301-538-3544
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 28105 THREE NOTCH RD
-----------------------------------------------------
City | MECHANICSVILLE
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20659-3235
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 301-538-3544
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number | LC4507
-----------------------------------------------------
License Number State | MD
-----------------------------------------------------