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NPI Code Detail

MEDICARE: KINDWAY COUNSELING, LLC

MEDICARE: KINDWAY 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
1101YM0800XMental Health Counselor
2251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1063261766
Entity Type Code : Organization
Provider Name (Legal Business Name) : KINDWAY COUNSELING, LLC
Provider Business Mailing Address
First Line : 11 BYTE CT STE C
Second Line :
City : FREDERICK
State : MD
Zip : 21702-8718
Country : US
Telephone Number : 301-276-5196
Fax Number :
Provider Business Practice Location Address
First Line : 11 BYTE CT STE C
Second Line :
City : FREDERICK
State : MD
Zip : 21702-8718
Country : US
Telephone Number : 301-276-5196
Fax Number :
Authorized Official
Title or Position : OWNER, COUNSELOR
Name : MR. LEONARD JASON ANTHONY JR.
Credential : LCPC, LMHC
Telephone Number : 773-727-7336
Provider Enumeration Date : 05/15/2024
Last Update Date : 05/15/2024

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Directions to “KINDWAY COUNSELING, LLC ” Practice Location

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