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General NPI Number Information
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NPI Number | 1972198562
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Entity Type | Organization
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Legal Business Name | WELL WITHIN COUNSELING, LLC
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Dates
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Enumeration Date | 03/04/2021
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Last Update Date | 03/04/2021
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Provider Practice Location Address
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Address Line | 150 N LAKEWOOD AVE
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City | BALTIMORE
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State | MD
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Zip | 21224-1143
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Country | US
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Telephone | 301-633-9485
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Fax | 443-652-6300
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Provider Business Mailing Address
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Address Line | 150 N LAKEWOOD AVE
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City | BALTIMORE
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State | MD
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Zip | 21224-1143
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Country | US
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Telephone | 301-633-9485
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Fax | 443-652-6300
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Authorized Official
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Title or Position | OWNER
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Name | MS. NICOLE ROSE MARTYN
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Credential | LCSW-C
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Telephone | 301-633-9485
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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