Provider Demographics
NPI:1659823474
Name:THE DREAMING TREE COUNSELING CENTER, LLC
Entity Type:Organization
Organization Name:THE DREAMING TREE COUNSELING CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIM
Authorized Official - Middle Name:WEIST
Authorized Official - Last Name:PIASECKI
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:301-355-0450
Mailing Address - Street 1:23016 TURTLE ROCK TER
Mailing Address - Street 2:
Mailing Address - City:CLARKSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20871-4505
Mailing Address - Country:US
Mailing Address - Phone:301-515-1465
Mailing Address - Fax:301-515-1937
Practice Address - Street 1:13240 EXECUTIVE PARK TER
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20874-2640
Practice Address - Country:US
Practice Address - Phone:301-355-0450
Practice Address - Fax:301-515-1937
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-27
Last Update Date:2016-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC2938101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty