Provider Demographics
NPI:1114466406
Name:CONNECT COUNSELING SERVICES, LLC
Entity Type:Organization
Organization Name:CONNECT COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:
Authorized Official - First Name:ELENA
Authorized Official - Middle Name:MELANIA
Authorized Official - Last Name:O'HATNICK
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:410-656-2646
Mailing Address - Street 1:7226 LEE DEFOREST DR
Mailing Address - Street 2:SUITE 206
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21046-3239
Mailing Address - Country:US
Mailing Address - Phone:410-656-2646
Mailing Address - Fax:410-709-9012
Practice Address - Street 1:7226 LEE DEFOREST DR
Practice Address - Street 2:SUITE 206
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21046-3239
Practice Address - Country:US
Practice Address - Phone:410-656-2646
Practice Address - Fax:410-709-9012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-20
Last Update Date:2017-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC3719101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty