Provider Demographics
NPI:1003295676
Name:DISCOVERY HARBOR COUNSELING CENTER LLC
Entity Type:Organization
Organization Name:DISCOVERY HARBOR COUNSELING CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL PROFESSIONAL COUN
Authorized Official - Prefix:
Authorized Official - First Name:URSULA
Authorized Official - Middle Name:
Authorized Official - Last Name:TOWLES
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:301-862-9600
Mailing Address - Street 1:22776 THREE NOTCH RD
Mailing Address - Street 2:SUITE #202
Mailing Address - City:LEXINGTON PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20653-3368
Mailing Address - Country:US
Mailing Address - Phone:301-862-9600
Mailing Address - Fax:
Practice Address - Street 1:22776 THREE NOTCH RD
Practice Address - Street 2:SUITE #202
Practice Address - City:LEXINGTON PARK
Practice Address - State:MD
Practice Address - Zip Code:20653-3368
Practice Address - Country:US
Practice Address - Phone:301-862-9600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-28
Last Update Date:2015-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC5015101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty