Provider Demographics
NPI:1336311471
Name:METROPOLITAN CONSULTANT AND PROFESSIONAL SERVICES
Entity Type:Organization
Organization Name:METROPOLITAN CONSULTANT AND PROFESSIONAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TENNEH
Authorized Official - Middle Name:JOHNSON
Authorized Official - Last Name:KEMAH
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-C
Authorized Official - Phone:301-362-6772
Mailing Address - Street 1:3005 SHORELINE BLVD
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20724-1965
Mailing Address - Country:US
Mailing Address - Phone:301-362-6772
Mailing Address - Fax:301-362-6772
Practice Address - Street 1:3005 SHORELINE BLVD
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20724-1965
Practice Address - Country:US
Practice Address - Phone:301-362-6772
Practice Address - Fax:301-362-6772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-28
Last Update Date:2008-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD11268251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health