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General NPI Number Information
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NPI Number | 1801402771
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Entity Type | Organization
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Legal Business Name | ESSENTIAL COUNSELING & WELLNESS CENTER LLC
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Dates
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Enumeration Date | 09/16/2020
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Last Update Date | 12/16/2020
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Provider Practice Location Address
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Address Line | 260 GATEWAY DR STE 21-22B
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City | BEL AIR
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State | MD
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Zip | 21014-4268
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Country | US
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Telephone | 443-424-3599
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Fax |
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Provider Business Mailing Address
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Address Line | 260 GATEWAY DR STE 21-22B
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City | BEL AIR
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State | MD
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Zip | 21014-4268
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Country | US
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Telephone | 443-424-3599
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | PRISCILLA REAVES
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Credential |
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Telephone | 410-949-5789
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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