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General NPI Number Information
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NPI Number | 1912344862
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Entity Type | Organization
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Legal Business Name | ASIA AL-MATEEN LCPC ACS
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Dates
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Enumeration Date | 06/02/2013
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Last Update Date | 06/02/2013
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Provider Practice Location Address
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Address Line | 515 N CHESTER ST B
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City | BALTIMORE
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State | MD
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Zip | 21205-2301
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Country | US
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Telephone | 410-982-1353
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Fax |
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Provider Business Mailing Address
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Address Line | 2909 FALLSTAFF RD 37
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City | BALTIMORE
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State | MD
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Zip | 21209-3226
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Country | US
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Telephone | 410-982-1353
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Fax | 443-766-1713
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Authorized Official
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Title or Position | OWNER
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Name | ASIA MARIA AL-MATEEN
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Credential | LCPC
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Telephone | 410-982-1353
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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 | 2133
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License Number State | MD
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