| Life Support Clinical Counseling Service Llc | |
|
82 Janet Dale Ln Severn MD 21144 | |
| (410) 980-3163 | |
| (410) 969-2958 |
| Full Name | Life Support Clinical Counseling Service Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 82 Janet Dale Ln, Severn, Maryland |
| Authorized Official Name and Position | Alice Rita Hunley (CEO) |
| Authorized Official Contact | 4109803163 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Life Support Clinical Counseling Service Llc 82 Janet Dale Ln Severn MD 21144 Ph: (410) 980-3163 | Life Support Clinical Counseling Service Llc 82 Janet Dale Ln Severn MD 21144 Ph: (410) 980-3163 |
| NPI Number | 1528538105 |
|---|---|
| Provider Enumeration Date | 11/27/2018 |
| Last Update Date | 11/27/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528538105 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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