Provider Demographics
NPI:1093007411
Name:COUNSELING PROFESSIONALS INCORPORATED
Entity Type:Organization
Organization Name:COUNSELING PROFESSIONALS INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:DIXON
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LCADC
Authorized Official - Phone:301-374-2013
Mailing Address - Street 1:3555 LEONARDTOWN RD
Mailing Address - Street 2:SUITE#8
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20601-3617
Mailing Address - Country:US
Mailing Address - Phone:301-374-2013
Mailing Address - Fax:301-374-2014
Practice Address - Street 1:3555 LEONARDTOWN RD
Practice Address - Street 2:SUITE#8
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20601-3617
Practice Address - Country:US
Practice Address - Phone:301-374-2013
Practice Address - Fax:301-374-2014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-03
Last Update Date:2011-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLCA456261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder