1881099133 NPI number — BAYSIDE CHRISTIAN COUNSELING AND CONSULTING, LLC

Table of content: ASHLEY JONES QMHS BA (NPI 1801481866)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881099133 NPI number — BAYSIDE CHRISTIAN COUNSELING AND CONSULTING, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BAYSIDE CHRISTIAN COUNSELING AND CONSULTING, LLC
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:
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:
1881099133
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/29/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9103 WOODMORE CENTER DR STE 204
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LANHAM
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20706-1653
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-467-6277
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9701 APOLLO DR STE 301
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LARGO
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20774-4790
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-467-6277
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/29/2014

Additional Information

Authorized Official

Authorized Official Last Name:
PEARSON
Authorized Official First Name:
LISA
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
301-467-6277

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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