Provider Demographics
NPI:1083005870
Name:THE COUNSELING CENTER OF MARYLAND
Entity Type:Organization
Organization Name:THE COUNSELING CENTER OF MARYLAND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARJONE
Authorized Official - Middle Name:LAUREN
Authorized Official - Last Name:KREPPEL
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:301-651-0303
Mailing Address - Street 1:8030 WOODMONT AVENUE
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814
Mailing Address - Country:US
Mailing Address - Phone:301-742-2282
Mailing Address - Fax:301-802-2146
Practice Address - Street 1:8030 WOODMONT AVENUE
Practice Address - Street 2:3RD FLOOR
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814
Practice Address - Country:US
Practice Address - Phone:301-742-2282
Practice Address - Fax:301-802-2146
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-15
Last Update Date:2018-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC6929101YM0800X
251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty