1083005870 NPI number — THE COUNSELING CENTER OF MARYLAND

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1083005870 NPI number — THE COUNSELING CENTER OF MARYLAND

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE COUNSELING CENTER OF MARYLAND
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:
1083005870
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/06/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8030 WOODMONT AVENUE
Provider Second Line Business Mailing Address:
3RD FLOOR
Provider Business Mailing Address City Name:
BETHESDA
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20814
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-742-2282
Provider Business Mailing Address Fax Number:
301-802-2146

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8030 WOODMONT AVENUE
Provider Second Line Business Practice Location Address:
3RD FLOOR
Provider Business Practice Location Address City Name:
BETHESDA
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20814
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-742-2282
Provider Business Practice Location Address Fax Number:
301-802-2146
Provider Enumeration Date:
02/15/2015

Additional Information

Authorized Official

Authorized Official Last Name:
KREPPEL
Authorized Official First Name:
MARJONE
Authorized Official Middle Name:
LAUREN
Authorized Official Title or Position:
FOUNDER/DIRECTOR
Authorized Official Telephone Number:
301-651-0303

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  LC6929 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 251S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





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