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General NPI Number Information
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NPI Number | 1841731916
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Entity Type | Organization
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Legal Business Name | HOPE AND FAITH COUNSELING & ED. SERVICES
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Dates
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Enumeration Date | 03/09/2017
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Last Update Date | 03/09/2017
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Provider Practice Location Address
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Address Line | 5906 PARK HEIGHTS AVE SUITE 107-12
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City | BALTIMORE
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State | MD
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Zip | 21215-3631
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Country | US
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Telephone | 410-236-6400
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Fax |
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Provider Business Mailing Address
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Address Line | 5906 PARK HEIGHTS AVE SUITE 107-12
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City | BALTIMORE
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State | MD
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Zip | 21215-3631
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Country | US
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Telephone | 410-236-6400
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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 | SHARON MICHELE KELLY
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Credential | L.C.S.W.-C
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Telephone | 410-236-6400
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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 | 14603
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License Number State | MD
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