| Emotional Abuse Support Team | |
|
1808 61st Ave Cheverly MD 20785-3803 | |
| (240) 319-0182 | |
| Not Available |
| Full Name | Emotional Abuse Support Team |
|---|---|
| Speciality | Counselor - Professional |
| Location | 1808 61st Ave, Cheverly, Maryland |
| Authorized Official Name and Position | Demarest Crawl (EXECUTIVE) |
| Authorized Official Contact | 2403190182 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Emotional Abuse Support Team 1808 61st Ave Cheverly MD 20785-3803 Ph: (240) 319-0182 | Emotional Abuse Support Team 1808 61st Ave Cheverly MD 20785-3803 Ph: (240) 319-0182 |
| NPI Number | 1336731116 |
|---|---|
| Provider Enumeration Date | 02/03/2021 |
| Last Update Date | 02/03/2021 |
| Certification Date | 02/03/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336731116 | NPI | - | NPPES |
| 1205355344 | Other | MD | NPI |
| 1023663325 | Other | MD | NPI |
| 822045000 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
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