Provider Demographics
NPI:1225274137
Name:SUGARLOAF COUNSELING & PSYCHOTHERAPY ASSOCIATES
Entity Type:Organization
Organization Name:SUGARLOAF COUNSELING & PSYCHOTHERAPY ASSOCIATES
Other - Org Name:MICHAEL L. ABRAHAMS LCSW-C
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:L
Authorized Official - Last Name:ABRAHAMS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-C
Authorized Official - Phone:301-428-3557
Mailing Address - Street 1:18 EXECUTIVE PARK CT
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20874-2645
Mailing Address - Country:US
Mailing Address - Phone:301-428-3557
Mailing Address - Fax:301-972-6635
Practice Address - Street 1:18 EXECUTIVE PARK CT
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20874-2645
Practice Address - Country:US
Practice Address - Phone:301-428-3557
Practice Address - Fax:301-972-6635
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-23
Last Update Date:2008-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC2107101YP2500X
MD28431041C0700X
MD129181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty