Provider Demographics
NPI:1568736007
Name:REMEDY COUNSELING, LLC
Entity Type:Organization
Organization Name:REMEDY COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER 10090
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRANDY
Authorized Official - Middle Name:TINA
Authorized Official - Last Name:MOBIN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-C
Authorized Official - Phone:410-431-5111
Mailing Address - Street 1:819 RITCHIE HWY STE 1020
Mailing Address - Street 2:
Mailing Address - City:SEVERNA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:21146-4193
Mailing Address - Country:US
Mailing Address - Phone:410-431-5111
Mailing Address - Fax:410-431-5112
Practice Address - Street 1:819 RITCHIE HWY STE 1020
Practice Address - Street 2:
Practice Address - City:SEVERNA PARK
Practice Address - State:MD
Practice Address - Zip Code:21146-4193
Practice Address - Country:US
Practice Address - Phone:410-431-5111
Practice Address - Fax:410-431-5112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-01
Last Update Date:2018-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD106681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD336638300Medicaid