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General NPI Number Information
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NPI Number | 1912400664
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Entity Type | Organization
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Legal Business Name | CARIN VENDITTA LCSW-C INC
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Dates
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Enumeration Date | 03/08/2018
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Last Update Date | 03/08/2018
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Provider Practice Location Address
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Address Line | 100 E MAIN ST STE 402
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City | SALISBURY
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State | MD
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Zip | 21801-5073
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Country | US
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Telephone | 443-614-3311
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Fax |
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Provider Business Mailing Address
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Address Line | 16 GATEHOUSE TRL
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City | BERLIN
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State | MD
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Zip | 21811-2023
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CARIN VENDITTA
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Credential | LCSW-C
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Telephone | 443-614-3311
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 08692
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License Number State | MD
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