| Work Life Behavioral Health And Professional Training Llc | |
|
7954 Baltimore Annapolis Blvd Suite 2-c Glen Burnie MD 21060-8188 | |
| (410) 487-6052 | |
| Not Available |
| Full Name | Work Life Behavioral Health And Professional Training Llc |
|---|---|
| Speciality | Social Worker |
| Location | 7954 Baltimore Annapolis Blvd, Glen Burnie, Maryland |
| Authorized Official Name and Position | Latoya Marie Nkongolo (OWNER/SOCIAL WORKER) |
| Authorized Official Contact | 4104876052 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Work Life Behavioral Health And Professional Training Llc 7954 Baltimore Annapolis Blvd Suite 2-c Glen Burnie MD 21060-8188 Ph: (410) 487-6052 | Work Life Behavioral Health And Professional Training Llc 7954 Baltimore Annapolis Blvd Suite 2-c Glen Burnie MD 21060-8188 Ph: (410) 487-6052 |
| NPI Number | 1235683947 |
|---|---|
| Provider Enumeration Date | 08/10/2016 |
| Last Update Date | 08/10/2016 |
| Medicare PECOS PAC ID | 3476833609 |
|---|---|
| Medicare Enrollment ID | O20161206000705 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235683947 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 19300 (Maryland) | Primary |
| Provider Name | Latoya M Nkongolo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487018354 PECOS PAC ID: 3577859339 Enrollment ID: I20161206000644 |
| Provider Name | Timothy J Dugan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942843263 PECOS PAC ID: 2860826633 Enrollment ID: I20200103000066 |
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