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General NPI Number Information
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NPI Number | 1881209815
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Entity Type | Organization
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Legal Business Name | STRIDE FORWARD COUNSELING LLC
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Dates
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Enumeration Date | 09/15/2020
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Last Update Date | 10/29/2020
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Provider Practice Location Address
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Address Line | 9 NEWBURG AVE STE 102
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City | CATONSVILLE
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State | MD
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Zip | 21228-5157
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Country | US
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Telephone | 916-572-1225
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Fax |
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Provider Business Mailing Address
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Address Line | 3506 LOWER MILL CT
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City | ELLICOTTY CITY
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State | MD
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Zip | 21043-4140
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Country | US
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Telephone | 443-851-8214
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Fax |
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Authorized Official
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Title or Position | CLINICAL THERAPIST
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Name | MRS. RACHEL NICOLE COLLINS
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Credential | LC10692
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Telephone | 443-851-8214
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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