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General NPI Number Information
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NPI Number | 1952955510
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Entity Type | Organization
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Legal Business Name | MSB COUNSELING SERVICES, LLC
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Dates
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Enumeration Date | 07/31/2019
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Last Update Date | 07/31/2019
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Provider Practice Location Address
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Address Line | 1110 BENFIELD BLVD STE H
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City | MILLERSVILLE
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State | MD
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Zip | 21108-2644
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Country | US
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Telephone | 443-787-9879
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Fax |
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Provider Business Mailing Address
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Address Line | 1815 GRAYMOUNT WAY
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City | EDGEWOOD
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State | MD
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Zip | 21040-3010
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Country | US
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Telephone | 443-787-9879
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Fax |
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Authorized Official
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Title or Position | MENTAL HEALTH THERAPIST
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Name | LAUREN WILLIAMS
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Credential | LCPC
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Telephone | 443-787-9879
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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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