| Connected Self, Llc | |
|
3012 Mitchellville Rd Suite 103 Bowie MD 20716-3986 | |
| (301) 218-0836 | |
| (301) 218-0836 |
| Full Name | Connected Self, Llc |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 3012 Mitchellville Rd, Bowie, Maryland |
| Authorized Official Name and Position | Merlina Alyce Perkowski (OWNER, SOLE THERAPIST) |
| Authorized Official Contact | 3012180836 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Connected Self, Llc 3012 Mitchellville Rd Suite 103 Bowie MD 20716-3986 Ph: (301) 218-0836 | Connected Self, Llc 3012 Mitchellville Rd Suite 103 Bowie MD 20716-3986 Ph: (301) 218-0836 |
| NPI Number | 1932270568 |
|---|---|
| Provider Enumeration Date | 11/13/2006 |
| Last Update Date | 03/10/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932270568 | NPI | - | NPPES |
| 361133 | Other | MD | MHN |
| 511509400 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | LCM130 (Maryland) | Primary |
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