Provider Demographics
NPI:1922688175
Name:RESONANT COUNSELING & PSYCHOTHERAPY LIMITED LIABILITY COMPANY
Entity Type:Organization
Organization Name:RESONANT COUNSELING & PSYCHOTHERAPY LIMITED LIABILITY COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:N
Authorized Official - Last Name:NGUGI
Authorized Official - Suffix:
Authorized Official - Credentials:LCMFT
Authorized Official - Phone:240-476-8266
Mailing Address - Street 1:1709 BARNETT CT
Mailing Address - Street 2:
Mailing Address - City:SEVERN
Mailing Address - State:MD
Mailing Address - Zip Code:21144-4413
Mailing Address - Country:US
Mailing Address - Phone:240-476-8266
Mailing Address - Fax:
Practice Address - Street 1:1709 BARNETT CT
Practice Address - Street 2:
Practice Address - City:SEVERN
Practice Address - State:MD
Practice Address - Zip Code:21144-4413
Practice Address - Country:US
Practice Address - Phone:240-476-8266
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-12
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1003386806Medicaid