Provider Demographics
NPI:1033419692
Name:RESTORING EVERY SOUL EACH TIME, LLC
Entity Type:Organization
Organization Name:RESTORING EVERY SOUL EACH TIME, LLC
Other - Org Name:RESET, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LICENSED PSYCHOTHERAPIST
Authorized Official - Prefix:MISS
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:LANGLEY
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:443-822-2446
Mailing Address - Street 1:203 BUTTONWOODS RD
Mailing Address - Street 2:
Mailing Address - City:ELKTON
Mailing Address - State:MD
Mailing Address - Zip Code:21921-6571
Mailing Address - Country:US
Mailing Address - Phone:443-822-2446
Mailing Address - Fax:443-350-9769
Practice Address - Street 1:203 BUTTONWOODS RD
Practice Address - Street 2:
Practice Address - City:ELKTON
Practice Address - State:MD
Practice Address - Zip Code:21921-6571
Practice Address - Country:US
Practice Address - Phone:443-822-2446
Practice Address - Fax:443-350-9769
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-29
Last Update Date:2010-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC2746101YP2500X
PAPC004912101YP2500X
DEPC-0000440101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD646097Medicaid