| Conversations Create Change Llc | |
|
574f Ritchie Hwy Ste 171 Severna Park MD 21146-2925 | |
| (301) 275-6962 | |
| Not Available |
| Full Name | Conversations Create Change Llc |
|---|---|
| Speciality | Counselor |
| Location | 574f Ritchie Hwy Ste 171, Severna Park, Maryland |
| Authorized Official Name and Position | Cynthia Agyeman-anane (SOCIAL WORKER) |
| Authorized Official Contact | 3012756962 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Conversations Create Change Llc 574f Ritchie Hwy Ste 171 Severna Park MD 21146-2925 Ph: (301) 275-6962 | Conversations Create Change Llc 574f Ritchie Hwy Ste 171 Severna Park MD 21146-2925 Ph: (301) 275-6962 |
| NPI Number | 1366926032 |
|---|---|
| Provider Enumeration Date | 09/19/2018 |
| Last Update Date | 09/17/2024 |
| Certification Date | 09/17/2024 |
| Medicare PECOS PAC ID | 7618217720 |
|---|---|
| Medicare Enrollment ID | O20190327000015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366926032 | NPI | - | NPPES |
| 743203800 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Cynthia Agyeman-anane |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427428812 PECOS PAC ID: 8123310497 Enrollment ID: I20160706001943 |
| Provider Name | Meagan Jennifer Desilva |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831437623 PECOS PAC ID: 1254667694 Enrollment ID: I20190724000044 |
| Provider Name | Monica Patricia Lester |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013146711 PECOS PAC ID: 4385061100 Enrollment ID: I20200825002346 |
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