MEDICARE: UNIDOS HEALING 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
1	261QM0855X	Adolescent and Children Mental Health Clinic/Center
2	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1093400665
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNIDOS HEALING COUNSELING, LLC

Provider Business Mailing Address
First Line	:	1400 MERCANTILE LN STE 244
Second Line	:
City	:	LARGO
State	:	MD
Zip	:	20774-5353
Country	:	US
Telephone Number	:	301-346-7780
Fax Number	:

Provider Business Practice Location Address
First Line	:	1400 MERCANTILE LN STE 244
Second Line	:
City	:	LARGO
State	:	MD
Zip	:	20774-5353
Country	:	US
Telephone Number	:	301-346-7780
Fax Number	:

Authorized Official
Title or Position	:	OWNER/THERAPIST
Name	:	URSULA CAMELO-CERRO
Credential	:	LCPC, LPC
Telephone Number	:	301-346-7780

Provider Enumeration Date	:	04/10/2023
Last Update Date	:	01/03/2024

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