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NPI Code Detail

MEDICARE: VILLAGE COUNSELING LLC

MEDICARE: VILLAGE 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
11041C0700XClinical Social Worker

General Provider Information

NPI Number : 1306488655
Entity Type Code : Organization
Provider Name (Legal Business Name) : VILLAGE COUNSELING LLC
Provider Business Mailing Address
First Line : 7132 COLLINGWOOD CT
Second Line :
City : ELKRIDGE
State : MD
Zip : 21075-5548
Country : US
Telephone Number : 757-651-3003
Fax Number : 757-222-3833
Provider Business Practice Location Address
First Line : 8181 MAIN ST APT 2
Second Line :
City : ELLICOTT CITY
State : MD
Zip : 21043-4929
Country : US
Telephone Number : 757-651-3003
Fax Number : 757-222-3833
Authorized Official
Title or Position : ADMINISTRATOR
Name : LOU PHILLIPS
Credential :
Telephone Number : 757-651-3003
Provider Enumeration Date : 10/08/2019
Last Update Date : 10/08/2019

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Directions to “VILLAGE COUNSELING LLC ” Practice Location

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