Provider Demographics
NPI:1114709409
Name:COUNSELORS IN THE COMMUNITY ASSOCIATION CO.
Entity Type:Organization
Organization Name:COUNSELORS IN THE COMMUNITY ASSOCIATION CO.
Other - Org Name:CITCA
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:HARRIS
Authorized Official - Last Name:STEVENSON
Authorized Official - Suffix:
Authorized Official - Credentials:MSIOP
Authorized Official - Phone:866-500-0133
Mailing Address - Street 1:145 W OSTEND ST STE 600
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21230-3774
Mailing Address - Country:US
Mailing Address - Phone:866-500-0133
Mailing Address - Fax:866-500-0133
Practice Address - Street 1:145 W OSTEND ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21230-3764
Practice Address - Country:US
Practice Address - Phone:866-500-0133
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-20
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
No171400000XOther Service ProvidersHealth & Wellness CoachGroup - Multi-Specialty
No174H00000XOther Service ProvidersHealth EducatorGroup - Multi-Specialty
No225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation CounselorGroup - Multi-Specialty