| True Life Change | |
|
5100 Buckeystown Pike Ste 250 Frederick MD 21704-8344 | |
| (410) 417-7556 | |
| Not Available |
| Full Name | True Life Change |
|---|---|
| Speciality | Counselor |
| Location | 5100 Buckeystown Pike Ste 250, Frederick, Maryland |
| Authorized Official Name and Position | Marsha Holevas (ADMINISTRATOR) |
| Authorized Official Contact | 4434189957 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| True Life Change 5100 Buckeystown Pike Ste 250 Frederick MD 21704-8344 Ph: () - | True Life Change 5100 Buckeystown Pike Ste 250 Frederick MD 21704-8344 Ph: (410) 417-7556 |
| NPI Number | 1285304626 |
|---|---|
| Provider Enumeration Date | 09/16/2021 |
| Last Update Date | 09/20/2021 |
| Certification Date | 09/20/2021 |
| Medicare PECOS PAC ID | 1759774128 |
|---|---|
| Medicare Enrollment ID | O20220207002033 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285304626 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Suzanne G Olesker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760408140 PECOS PAC ID: 4082651559 Enrollment ID: I20050415000413 |
| Provider Name | Mary B Mcallen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902382138 PECOS PAC ID: 4587992516 Enrollment ID: I20190828002918 |
| Provider Name | Shontel M Gaskin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942828082 PECOS PAC ID: 3072920099 Enrollment ID: I20210318000949 |
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