Provider Demographics
NPI:1952646010
Name:OLNEY PSYCHIATRIC AND COUNSELING CENTER LLC
Entity Type:Organization
Organization Name:OLNEY PSYCHIATRIC AND COUNSELING CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:WELLS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-C
Authorized Official - Phone:301-570-7500
Mailing Address - Street 1:3430 N HIGH ST
Mailing Address - Street 2:
Mailing Address - City:OLNEY
Mailing Address - State:MD
Mailing Address - Zip Code:20832-2202
Mailing Address - Country:US
Mailing Address - Phone:301-570-7500
Mailing Address - Fax:301-570-7504
Practice Address - Street 1:3430 N HIGH ST
Practice Address - Street 2:
Practice Address - City:OLNEY
Practice Address - State:MD
Practice Address - Zip Code:20832-2202
Practice Address - Country:US
Practice Address - Phone:301-570-7500
Practice Address - Fax:301-570-7504
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-30
Last Update Date:2012-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)