Provider Demographics
NPI:1033231204
Name:CHESAPEAKE COUNSELING ASSOCIATES, LLC
Entity Type:Organization
Organization Name:CHESAPEAKE COUNSELING ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:THIEL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSWC
Authorized Official - Phone:301-231-9001
Mailing Address - Street 1:10705 HAMPTON MILL TER APT 100
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-5450
Mailing Address - Country:US
Mailing Address - Phone:301-231-9001
Mailing Address - Fax:301-231-0124
Practice Address - Street 1:4701 RANDOLPH RD STE G8
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-2259
Practice Address - Country:US
Practice Address - Phone:301-231-9001
Practice Address - Fax:301-231-0124
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD125801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty