Provider Demographics
NPI:1033821483
Name:EXPANDING HORIZONS COUNSELING AND WELLNESS
Entity Type:Organization
Organization Name:EXPANDING HORIZONS COUNSELING AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:COURTNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:CONLEY
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:814-366-1072
Mailing Address - Street 1:6370 GRANT CHAPMAN DR
Mailing Address - Street 2:
Mailing Address - City:LA PLATA
Mailing Address - State:MD
Mailing Address - Zip Code:20646-3524
Mailing Address - Country:US
Mailing Address - Phone:814-366-1072
Mailing Address - Fax:
Practice Address - Street 1:5 N MAPLE AVE STE 206
Practice Address - Street 2:
Practice Address - City:LA PLATA
Practice Address - State:MD
Practice Address - Zip Code:20646-3744
Practice Address - Country:US
Practice Address - Phone:240-776-4519
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-16
Last Update Date:2022-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty