Provider Demographics
NPI:1588207955
Name:BAY AREA COUNSELING & CONSULTATION, LLC
Entity Type:Organization
Organization Name:BAY AREA COUNSELING & CONSULTATION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:COURTNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-C
Authorized Official - Phone:410-430-8181
Mailing Address - Street 1:2048 KURTZ AVE # HOUSEA
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:MD
Mailing Address - Zip Code:21122-3525
Mailing Address - Country:US
Mailing Address - Phone:410-430-8181
Mailing Address - Fax:
Practice Address - Street 1:1410 CRAIN HWY N STE 1B
Practice Address - Street 2:
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-9304
Practice Address - Country:US
Practice Address - Phone:410-541-6476
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-17
Last Update Date:2019-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty