Provider Demographics
NPI:1194211995
Name:CARAEL GROUP, LLC
Entity Type:Organization
Organization Name:CARAEL GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF THERAPIST/CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:LATONIA
Authorized Official - Middle Name:D
Authorized Official - Last Name:STATEN
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:240-599-8060
Mailing Address - Street 1:13911 HIGHSTREAM PL
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20874-6161
Mailing Address - Country:US
Mailing Address - Phone:240-778-9962
Mailing Address - Fax:
Practice Address - Street 1:199 E MONTGOMERY AVE STE 100
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-2361
Practice Address - Country:US
Practice Address - Phone:240-599-8060
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-03
Last Update Date:2018-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC8789101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty