| Essential Credentials Coaching, Llc | |
|
3407 W Forest Park Ave Baltimore MD 21216-1453 | |
| (443) 742-4329 | |
| Not Available |
| Full Name | Essential Credentials Coaching, Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 3407 W Forest Park Ave, Baltimore, Maryland |
| Authorized Official Name and Position | Stacey Larise Robinson (OWNER) |
| Authorized Official Contact | 4437424329 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Essential Credentials Coaching, Llc 3407 W Forest Park Ave Baltimore MD 21216-1453 Ph: (443) 742-4329 | Essential Credentials Coaching, Llc 3407 W Forest Park Ave Baltimore MD 21216-1453 Ph: (443) 742-4329 |
| NPI Number | 1942858568 |
|---|---|
| Provider Enumeration Date | 08/27/2019 |
| Last Update Date | 08/27/2019 |
| Medicare PECOS PAC ID | 1658603840 |
|---|---|
| Medicare Enrollment ID | O20191021001534 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942858568 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Stacey Larise Robinson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265688345 PECOS PAC ID: 9931418027 Enrollment ID: I20151012000194 |
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