| Alternative Counseling & Wellness Center, Llc | |
|
200 E Joppa Rd Ste 407 Towson MD 21286-3109 | |
| (410) 828-0101 | |
| (410) 828-6262 |
| Full Name | Alternative Counseling & Wellness Center, Llc |
|---|---|
| Speciality | Counselor |
| Location | 200 E Joppa Rd Ste 407, Towson, Maryland |
| Authorized Official Name and Position | Victoria S Shequine (OWNER) |
| Authorized Official Contact | 4104333737 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Alternative Counseling & Wellness Center, Llc 200 E Joppa Rd Ste 407 Towson MD 21286-3109 Ph: (410) 828-0101 | Alternative Counseling & Wellness Center, Llc 200 E Joppa Rd Ste 407 Towson MD 21286-3109 Ph: (410) 828-0101 |
| NPI Number | 1164689576 |
|---|---|
| Provider Enumeration Date | 05/22/2008 |
| Last Update Date | 04/01/2022 |
| Certification Date | 03/28/2022 |
| Medicare PECOS PAC ID | 3375729429 |
|---|---|
| Medicare Enrollment ID | O20110525000525 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164689576 | NPI | - | NPPES |
| 441156100 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | LC1004 (Maryland) | Primary |
| Provider Name | Wendy E Kelly |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548283666 PECOS PAC ID: 5698868370 Enrollment ID: I20070911000820 |
| Provider Name | Candace C Crew |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619021581 PECOS PAC ID: 1456544154 Enrollment ID: I20101026000246 |
| Provider Name | Melanie F Levine |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629202916 PECOS PAC ID: 2163609728 Enrollment ID: I20110607000783 |
| Provider Name | Hilary A Fink |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003198649 PECOS PAC ID: 0840434130 Enrollment ID: I20130927000046 |
| Provider Name | Robin Ann Brown |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023424959 PECOS PAC ID: 4284852633 Enrollment ID: I20140826001870 |
| Provider Name | Ashley Marie Miller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558795609 PECOS PAC ID: 5496038325 Enrollment ID: I20170220000852 |
| Provider Name | Jodi L Dively |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255461125 PECOS PAC ID: 1153630546 Enrollment ID: I20170505000773 |
| Provider Name | Dona L Moon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982869004 PECOS PAC ID: 7810033545 Enrollment ID: I20180208000208 |
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