Provider Demographics
NPI:1902379696
Name:UNLOCKING RESILIENCE, LLC
Entity Type:Organization
Organization Name:UNLOCKING RESILIENCE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHILD AND FAMILY THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:CANBY
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW-C
Authorized Official - Phone:240-986-3139
Mailing Address - Street 1:1 SAHALEE CT
Mailing Address - Street 2:
Mailing Address - City:MARTINSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:25403-7307
Mailing Address - Country:US
Mailing Address - Phone:304-616-2396
Mailing Address - Fax:
Practice Address - Street 1:22 N MULBERRY ST STE 14&120
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-4870
Practice Address - Country:US
Practice Address - Phone:240-986-3139
Practice Address - Fax:301-576-3828
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-06
Last Update Date:2019-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty