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General NPI Number Information
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NPI Number | 1902269814
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Entity Type | Organization
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Legal Business Name | COURTNEY BIANCHI, LCSW-C, LLC
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Dates
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Enumeration Date | 03/30/2016
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Last Update Date | 03/30/2016
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Provider Practice Location Address
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Address Line | 1190 WINTERSON RD SUITE 160
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City | LINTHICUM
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State | MD
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Zip | 21090-2209
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Country | US
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Telephone | 443-354-8630
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Fax |
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Provider Business Mailing Address
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Address Line | 1190 WINTERSON RD SUITE 160
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City | LINTHICUM
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State | MD
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Zip | 21090-2209
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Country | US
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Telephone | 443-790-0149
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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 | MRS. COURTNEY BIANCHI
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Credential | LCSW-C
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Telephone | 443-354-8630
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number | 12568
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License Number State | MD
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