Provider Demographics
NPI:1821552019
Name:POSITIVELY INSPIRED COUNSELING LLC
Entity Type:Organization
Organization Name:POSITIVELY INSPIRED COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCPC
Authorized Official - Prefix:
Authorized Official - First Name:DANA
Authorized Official - Middle Name:ELAINE
Authorized Official - Last Name:ISOM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-812-1157
Mailing Address - Street 1:9841 WASHINGTONIAN BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20878-7350
Mailing Address - Country:US
Mailing Address - Phone:240-812-1157
Mailing Address - Fax:
Practice Address - Street 1:9841 WASHINGTONIAN BLVD STE 200
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20878-7350
Practice Address - Country:US
Practice Address - Phone:240-812-1157
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-22
Last Update Date:2019-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)