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NPI Code Detail

MEDICARE: LIBERTY COUNSELING

MEDICARE: LIBERTY COUNSELING
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

General Provider Information

NPI Number : 1417787839
Entity Type Code : Organization
Provider Name (Legal Business Name) : LIBERTY COUNSELING
Provider Business Mailing Address
First Line : 3355 SAINT JOHNS LN STE F
Second Line :
City : ELLICOTT CITY
State : MD
Zip : 21042-2600
Country : US
Telephone Number : 410-775-6270
Fax Number :
Provider Business Practice Location Address
First Line : 3355 SAINT JOHNS LN STE F
Second Line :
City : ELLICOTT CITY
State : MD
Zip : 21042-2600
Country : US
Telephone Number : 410-775-6270
Fax Number :
Authorized Official
Title or Position : FOUNDER
Name : LINA KOTSOEVA
Credential : LCPC
Telephone Number : 410-775-6270
Provider Enumeration Date : 08/02/2024
Last Update Date : 01/14/2026

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Directions to “LIBERTY COUNSELING ” Practice Location

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