Provider Demographics
NPI:1750717286
Name:ASCENSION COUNSELING SERVICES, LLC
Entity type:Organization
Organization Name:ASCENSION COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANNETTE
Authorized Official - Middle Name:DIANE
Authorized Official - Last Name:LEVESQUE-NIEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSWC
Authorized Official - Phone:410-455-0098
Mailing Address - Street 1:903 EDMONDSON AVE
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-4408
Mailing Address - Country:US
Mailing Address - Phone:410-455-0098
Mailing Address - Fax:410-455-9804
Practice Address - Street 1:903 EDMONDSON AVE
Practice Address - Street 2:
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-4408
Practice Address - Country:US
Practice Address - Phone:410-455-0098
Practice Address - Fax:410-455-9804
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-16
Last Update Date:2013-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC4640101YP2500X
MD121651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty