| Guiding Light Therapeutic Services | |
|
4404 Queensbury Rd Ste 105 Riverdale MD 20737-1074 | |
| (301) 379-4211 | |
| Not Available |
| Full Name | Guiding Light Therapeutic Services |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 4404 Queensbury Rd Ste 105, Riverdale, Maryland |
| Authorized Official Name and Position | Nodia Marshall (OWNER) |
| Authorized Official Contact | 3013794211 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Guiding Light Therapeutic Services 4404 Queensbury Rd Ste 105 Riverdale MD 20737-1074 Ph: (301) 379-4211 | Guiding Light Therapeutic Services 4404 Queensbury Rd Ste 105 Riverdale MD 20737-1074 Ph: (301) 379-4211 |
| NPI Number | 1376056598 |
|---|---|
| Provider Enumeration Date | 11/09/2017 |
| Last Update Date | 06/16/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376056598 | NPI | - | NPPES |
| 11556100 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | PRC14502 (District Of Columbia) | Primary |
| 101YM0800X | Counselor - Mental Health | LC6789 (Maryland) | Secondary |
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