Provider Demographics
NPI:1164479838
Name:LAUREL-BELTSVILLE OASIS
Entity Type:Organization
Organization Name:LAUREL-BELTSVILLE OASIS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LORRAINE
Authorized Official - Middle Name:
Authorized Official - Last Name:WOODS
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:301-498-4500
Mailing Address - Street 1:13992 BALTIMORE AVE
Mailing Address - Street 2:SUITE 203
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-5010
Mailing Address - Country:US
Mailing Address - Phone:301-498-4500
Mailing Address - Fax:301-498-4502
Practice Address - Street 1:13992 BALTIMORE AVE
Practice Address - Street 2:SUITE 203
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-5010
Practice Address - Country:US
Practice Address - Phone:301-498-4500
Practice Address - Fax:301-498-4502
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty