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NPI Code Detail

MEDICARE: CLARITY COVE COUNSELING LLC

MEDICARE: CLARITY COVE COUNSELING LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
125432OTHERMDLCSW LICENSE MD
2C012067OTHERNCLCSW NC

General Provider Information

NPI Number : 1023645488
Entity Type Code : Organization
Provider Name (Legal Business Name) : CLARITY COVE COUNSELING LLC
Provider Business Mailing Address
First Line : 2925 QUEENSBERRY DR
Second Line :
City : HUNTINGTOWN
State : MD
Zip : 20639-2325
Country : US
Telephone Number : 774-413-0157
Fax Number :
Provider Business Practice Location Address
First Line : 9120 CHESAPEAKE AVE STE 101D
Second Line :
City : NORTH BEACH
State : MD
Zip : 20714-5043
Country : US
Telephone Number : 301-818-9954
Fax Number : 301-818-9974
Authorized Official
Title or Position : SOCIAL WORKER
Name : MRS. ADRIENNE CLAIRE JEFFRIES
Credential : LCSW
Telephone Number : 774-413-0157
Provider Enumeration Date : 03/25/2020
Last Update Date : 03/25/2020

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Directions to “CLARITY COVE COUNSELING LLC ” Practice Location

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