MEDICARE: AWAY OF CHANGE COUNSELING SERVICE, 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	101YM0800X	Mental Health Counselor	LCA2042	MD

General Provider Information

NPI Number	:	1235623968
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AWAY OF CHANGE COUNSELING SERVICE, LLC

Provider Business Mailing Address
First Line	:	5310 OLD COURT RD STE 304
Second Line	:
City	:	RANDALLSTOWN
State	:	MD
Zip	:	21133-6202
Country	:	US
Telephone Number	:	443-405-3193
Fax Number	:	443-272-7572

Provider Business Practice Location Address
First Line	:	6609 REISTERSTOWN RD STE 206
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21215-2315
Country	:	US
Telephone Number	:	443-405-3193
Fax Number	:	443-272-7572

Authorized Official
Title or Position	:	FOUNDER AND CEO
Name	:	MS. DORIS ALLEN
Credential	:	MED, M.S., LCADC
Telephone Number	:	443-922-8928

Provider Enumeration Date	:	06/16/2018
Last Update Date	:	03/18/2021

Similar Medicare Providers

1407960032 — STEVEN ALLEN BLACKWELL PH.D., J.D., R.PH.
Practice Location Address:

7500 SECURITY BLVD # C3-20-17 , CENTERS FOR MEDICARE & MEDICAID SERVICES
BALTIMORE, MD
21244-1849

Practice Phone: 410-786-6852
Practice Fax:

1396961561 — DR. MARSHA SMITH MD
Practice Location Address:

7500 SECURITY BOULEVARD , CENTERS FOR MEDICARE & MEDICAID SERVICES
BALTIMORE, MD
21201-2301

Practice Phone: 410-786-6614
Practice Fax:

1134335441 — JULIE DAWN PREIS
Practice Location Address:

7500 SECURITY BLVD MS C1-13-07 , CENTERS FOR MEDICARE & MEDICAID SERVICES
BALTIMORE, MD
21244

Practice Phone: 410-786-0525
Practice Fax:

1578523379 — RENAL TREATMENT CENTERS MID ATLANTIC INC
Practice Location Address:

6609 REISTERSTOWN RD , STE 100
BALTIMORE, MD
21215-2315

Practice Phone: 410-358-1745
Practice Fax: 410-358-1526

1669497350 — MS. MARGARET ANN BROWN LCSW-C
Practice Location Address:

6609 REISTERSTOWN RD , SUITE 209
BALTIMORE, MD
21215-2315

Practice Phone: 410-585-1225
Practice Fax:

1407007289 — 4 WALLS HEALTH SERVICES INC.
Practice Location Address:

6609 REISTERSTOWN RD , SUITE 104
BALTIMORE, MD
21215-2315

Practice Phone: 443-762-6949
Practice Fax:

Directions to “AWAY OF CHANGE COUNSELING SERVICE, LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.