Provider Demographics
NPI:1760727069
Name:ADULT & ADOLESCENT COUNSELING SERVICES, LLC
Entity Type:Organization
Organization Name:ADULT & ADOLESCENT COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL PROFESSIONAL COUN
Authorized Official - Prefix:MS
Authorized Official - First Name:GISELA
Authorized Official - Middle Name:DE LA PENA
Authorized Official - Last Name:BAPTISTE
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:410-992-2224
Mailing Address - Street 1:8640 GUILFORD RD
Mailing Address - Street 2:SUITE 251
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21046-2655
Mailing Address - Country:US
Mailing Address - Phone:410-992-2224
Mailing Address - Fax:
Practice Address - Street 1:8640 GUILFORD RD
Practice Address - Street 2:SUITE 251
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21046-2655
Practice Address - Country:US
Practice Address - Phone:410-992-2224
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-28
Last Update Date:2012-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC4436101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty