| Totally Whole Pastoral Counseling Services, Llc | |
|
1701 Madison Ave Suite 500 Baltimore MD 21217-3731 | |
| (410) 728-1800 | |
| (410) 728-1808 |
| Full Name | Totally Whole Pastoral Counseling Services, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 1701 Madison Ave, Baltimore, Maryland |
| Authorized Official Name and Position | Rosemary Johnson (CEO) |
| Authorized Official Contact | 4107281800 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Totally Whole Pastoral Counseling Services, Llc 1701 Madison Ave Suite 500 Baltimore MD 21217-3731 Ph: (410) 728-1800 | Totally Whole Pastoral Counseling Services, Llc 1701 Madison Ave Suite 500 Baltimore MD 21217-3731 Ph: (410) 728-1800 |
| NPI Number | 1811341548 |
|---|---|
| Provider Enumeration Date | 04/19/2016 |
| Last Update Date | 04/19/2016 |
| Medicare PECOS PAC ID | 9032405717 |
|---|---|
| Medicare Enrollment ID | O20160906002186 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811341548 | NPI | - | NPPES |
| 1583107 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 06625 (Maryland) | Primary |
| Provider Name | Rosemary Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255515482 PECOS PAC ID: 8224214044 Enrollment ID: I20110512000266 |
| Provider Name | Tiera York Jones |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679928204 PECOS PAC ID: 7618389776 Enrollment ID: I20201214001615 |
| Provider Name | Ronnie C Drake |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1760863179 PECOS PAC ID: 7012353477 Enrollment ID: I20240308000442 |
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