Provider Demographics
NPI:1629429618
Name:FREDERICK COUNSELING LLC
Entity Type:Organization
Organization Name:FREDERICK COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:HADFIELD
Authorized Official - Suffix:I
Authorized Official - Credentials:MS LCPC
Authorized Official - Phone:301-639-6125
Mailing Address - Street 1:120 W CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701-7800
Mailing Address - Country:US
Mailing Address - Phone:301-639-6125
Mailing Address - Fax:
Practice Address - Street 1:120 W CHURCH ST
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-7800
Practice Address - Country:US
Practice Address - Phone:301-639-6125
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-30
Last Update Date:2016-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC291251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health