Provider Demographics
NPI:1073788725
Name:DESTILEE CONSULTING LLC
Entity Type:Organization
Organization Name:DESTILEE CONSULTING LLC
Other - Org Name:DESTILEE HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:VANESSA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAPPELL LEE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:443-244-7615
Mailing Address - Street 1:98 KLEE MILL RD
Mailing Address - Street 2:
Mailing Address - City:SYKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21784-9236
Mailing Address - Country:US
Mailing Address - Phone:443-244-7615
Mailing Address - Fax:443-303-4320
Practice Address - Street 1:98 KLEE MILL ROAD
Practice Address - Street 2:
Practice Address - City:SYKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21784
Practice Address - Country:US
Practice Address - Phone:443-244-7615
Practice Address - Fax:443-303-4320
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DESTILEE CONSULTING LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-04-24
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty