Provider Demographics
NPI:1558836239
Name:AGAPE COUNSELING OF MARYLAND
Entity Type:Organization
Organization Name:AGAPE COUNSELING OF MARYLAND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:FLEMING
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:443-371-3256
Mailing Address - Street 1:506 SUMMIT DR
Mailing Address - Street 2:
Mailing Address - City:FALLSTON
Mailing Address - State:MD
Mailing Address - Zip Code:21047-2616
Mailing Address - Country:US
Mailing Address - Phone:443-371-3256
Mailing Address - Fax:
Practice Address - Street 1:418 S MAIN ST
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-3920
Practice Address - Country:US
Practice Address - Phone:443-371-3256
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-09
Last Update Date:2018-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty