Provider Demographics
NPI:1518413343
Name:UNIVERSAL PROFESSIONAL COUNSELING
Entity type:Organization
Organization Name:UNIVERSAL PROFESSIONAL COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:DARIUS
Authorized Official - Middle Name:
Authorized Official - Last Name:DRISKELL
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:301-322-7905
Mailing Address - Street 1:1512 KINGSHILL ST
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-2035
Mailing Address - Country:US
Mailing Address - Phone:301-322-7905
Mailing Address - Fax:
Practice Address - Street 1:6490 LANDOVER ROAD SUITE C ROOM 10
Practice Address - Street 2:
Practice Address - City:CHEVERLY
Practice Address - State:MD
Practice Address - Zip Code:20785
Practice Address - Country:US
Practice Address - Phone:301-322-7905
Practice Address - Fax:301-322-7906
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-31
Last Update Date:2016-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC1899101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty