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General NPI Number Information
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NPI Number | 1841835824
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Entity Type | Organization
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Legal Business Name | UPCOUNTY PASTORAL COUNSELING SERVICES, LLC
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Dates
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Enumeration Date | 11/13/2019
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Last Update Date | 11/13/2019
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Provider Practice Location Address
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Address Line | 915 RUSSELL AVE STE B
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City | GAITHERSBURG
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State | MD
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Zip | 20879-6200
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Country | US
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Telephone | 240-401-8686
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Fax | 888-977-1530
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Provider Business Mailing Address
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Address Line | 8 RUSSELL AVE UNIT 402
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City | GAITHERSBURG
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State | MD
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Zip | 20877-2965
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Country | US
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Telephone | 240-401-8686
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Fax | 888-977-1530
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Authorized Official
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Title or Position | OWNER/LEAD CLINICIAN
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Name | CATHERINE EATON
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Credential | LCPC
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Telephone | 240-401-8686
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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