1174687552 NPI number — THE FAMILY COUNSELING CENTER OF LAUREL

Table of content: LILIYA MARATOVNA YAUSHEVA MD (NPI 1699260398)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174687552 NPI number — THE FAMILY COUNSELING CENTER OF LAUREL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE FAMILY COUNSELING CENTER OF LAUREL
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1174687552
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/05/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6 DELFORD AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SILVER SPRING
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20904
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-776-9492
Provider Business Mailing Address Fax Number:
301-625-0864

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6 DELFORD AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SILVER SPRING
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20904-3401
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-776-9492
Provider Business Practice Location Address Fax Number:
301-625-0864
Provider Enumeration Date:
12/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
WEINSTEIN
Authorized Official First Name:
MYRA
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
301-776-9492

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  C5194 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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