Provider Demographics
NPI:1932725900
Name:HACKLEY, RHONDA M (LGPC, NCC)
Entity Type:Individual
Prefix:
First Name:RHONDA
Middle Name:M
Last Name:HACKLEY
Suffix:
Gender:F
Credentials:LGPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6121 GRENFELL LOOP
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20720-5338
Mailing Address - Country:US
Mailing Address - Phone:301-464-7398
Mailing Address - Fax:
Practice Address - Street 1:3327 SUPERIOR LN STE 206
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20715-1941
Practice Address - Country:US
Practice Address - Phone:240-206-8345
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-24
Last Update Date:2020-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP9800101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
1154552OtherNATIONAL BOARD OF CERTIFIED COUNSELORS
MDLGP9800OtherMARYLAND DEPARTMENT OF HEALTH