Provider Demographics
NPI:1336475524
Name:HARFORD COUNTY COUNSELING SERVICES, LLC.
Entity Type:Organization
Organization Name:HARFORD COUNTY COUNSELING SERVICES, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SHANA
Authorized Official - Middle Name:JANINE
Authorized Official - Last Name:MISLAK
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-C,CCDC
Authorized Official - Phone:410-893-7217
Mailing Address - Street 1:801 CHANCE COURT
Mailing Address - Street 2:
Mailing Address - City:STREET
Mailing Address - State:MD
Mailing Address - Zip Code:21154
Mailing Address - Country:US
Mailing Address - Phone:410-893-7217
Mailing Address - Fax:
Practice Address - Street 1:801 CHANCE CT
Practice Address - Street 2:
Practice Address - City:STREET
Practice Address - State:MD
Practice Address - Zip Code:21154-1648
Practice Address - Country:US
Practice Address - Phone:410-893-7217
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-23
Last Update Date:2009-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD06960251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health