Provider Demographics
NPI:1508643032
Name:BUILT TO WIN COUNSELING SERVICES
Entity Type:Organization
Organization Name:BUILT TO WIN COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:LATIVIA
Authorized Official - Middle Name:SHANTE
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC, NCC, CTP
Authorized Official - Phone:240-702-8168
Mailing Address - Street 1:9500 BAYMAR CT
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MD
Mailing Address - Zip Code:20735-3399
Mailing Address - Country:US
Mailing Address - Phone:240-702-8168
Mailing Address - Fax:
Practice Address - Street 1:9500 BAYMAR CT
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MD
Practice Address - Zip Code:20735-3399
Practice Address - Country:US
Practice Address - Phone:240-702-8168
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-08
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health