Provider Demographics
NPI:1881209815
Name:STRIDE FORWARD COUNSELING LLC
Entity Type:Organization
Organization Name:STRIDE FORWARD COUNSELING LLC
Other - Org Name:STRIDE FORWARD COUNSELING LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINICAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:LC10692
Authorized Official - Phone:443-851-8214
Mailing Address - Street 1:3506 LOWER MILL CT
Mailing Address - Street 2:
Mailing Address - City:ELLICOTTY CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21043-4140
Mailing Address - Country:US
Mailing Address - Phone:443-851-8214
Mailing Address - Fax:
Practice Address - Street 1:9 NEWBURG AVE STE 102
Practice Address - Street 2:
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-5157
Practice Address - Country:US
Practice Address - Phone:916-572-1225
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-15
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health