| Diversity Counseling Associates, Llc | |
|
1300 Mercantile Ln Ste 129-17 Largo MD 20774-5327 | |
| (301) 814-3764 | |
| (240) 770-6916 |
| Full Name | Diversity Counseling Associates, Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 1300 Mercantile Ln Ste 129-17, Largo, Maryland |
| Authorized Official Name and Position | Sam Okanume (CEO) |
| Authorized Official Contact | 3018143764 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Diversity Counseling Associates, Llc 14111 Mary Bowie Pkwy Upper Marlboro MD 20774-8572 Ph: (301) 814-3764 | Diversity Counseling Associates, Llc 1300 Mercantile Ln Ste 129-17 Largo MD 20774-5327 Ph: (301) 814-3764 |
| NPI Number | 1801422100 |
|---|---|
| Provider Enumeration Date | 03/18/2020 |
| Last Update Date | 03/18/2020 |
| Certification Date | 03/18/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801422100 | NPI | - | NPPES |
| 129376100 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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