Provider Demographics
NPI:1164905188
Name:ATTT COUNSELING SERVICES , LLC
Entity Type:Organization
Organization Name:ATTT COUNSELING SERVICES , LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:EJIM
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC,CAC-AD
Authorized Official - Phone:443-731-2349
Mailing Address - Street 1:6918 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:ROSEDALE
Mailing Address - State:MD
Mailing Address - Zip Code:21237-3854
Mailing Address - Country:US
Mailing Address - Phone:443-731-2349
Mailing Address - Fax:
Practice Address - Street 1:7902 BELAIR RD STE 3
Practice Address - Street 2:
Practice Address - City:NOTTINGHAM
Practice Address - State:MD
Practice Address - Zip Code:21236-3707
Practice Address - Country:US
Practice Address - Phone:443-721-7574
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-14
Last Update Date:2021-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty