Provider Demographics
NPI:1689847311
Name:NORTH CARROLL COUNSELING CENTER
Entity Type:Organization
Organization Name:NORTH CARROLL COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:A
Authorized Official - Last Name:KANE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-552-9007
Mailing Address - Street 1:1381 JAY RD
Mailing Address - Street 2:
Mailing Address - City:ELDERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:21784-6115
Mailing Address - Country:US
Mailing Address - Phone:410-552-9007
Mailing Address - Fax:410-552-9881
Practice Address - Street 1:1011 MAIN ST
Practice Address - Street 2:
Practice Address - City:HAMPSTEAD
Practice Address - State:MD
Practice Address - Zip Code:21074-2230
Practice Address - Country:US
Practice Address - Phone:410-552-9007
Practice Address - Fax:410-552-9881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-02
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC0931101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty