Provider Demographics
NPI:1114438108
Name:OLNEY COUNSELING CENTER LLC
Entity Type:Organization
Organization Name:OLNEY COUNSELING CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:HEATHER
Authorized Official - Last Name:ROSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-570-7500
Mailing Address - Street 1:3300 OLNEY SANDY SPRING RD STE 340
Mailing Address - Street 2:
Mailing Address - City:OLNEY
Mailing Address - State:MD
Mailing Address - Zip Code:20832-3306
Mailing Address - Country:US
Mailing Address - Phone:301-570-7500
Mailing Address - Fax:301-570-7504
Practice Address - Street 1:3300 OLNEY SANDY SPRING RD STE 340
Practice Address - Street 2:
Practice Address - City:OLNEY
Practice Address - State:MD
Practice Address - Zip Code:20832-3306
Practice Address - Country:US
Practice Address - Phone:301-570-7500
Practice Address - Fax:301-570-7504
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-17
Last Update Date:2017-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty