Provider Demographics
NPI:1912581505
Name:CONGRUENCE COUNSELING & PSYCHOLOGY, LLC
Entity Type:Organization
Organization Name:CONGRUENCE COUNSELING & PSYCHOLOGY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DARREN
Authorized Official - Middle Name:J
Authorized Official - Last Name:FREEMAN-COPPADGE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, PHARMD, BCPP
Authorized Official - Phone:240-994-6346
Mailing Address - Street 1:1125 WEST STREET
Mailing Address - Street 2:SUITE 607
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401
Mailing Address - Country:US
Mailing Address - Phone:240-994-6346
Mailing Address - Fax:
Practice Address - Street 1:1125 WEST STREET
Practice Address - Street 2:SUITE 607
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401
Practice Address - Country:US
Practice Address - Phone:443-832-6750
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-10
Last Update Date:2021-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health