| Organization Name: | PAX RIVER COUNSELING, LLC |
| NPI Number: | 1063827756 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | HELENA LOUISE WEISL (MEMBER) |
| Mailing Address: | 22776 Three Notch Rd Suite 102 Lexington Park |
| State: | MD US |
| Postal Code: | 206533368 |
| Phone Number: | 6103486682 |
| Fax Number: | 3017803639 |
| NPI Enumeration Date: | 06/22/2014 |
| NPI Last Update Date: | 06/22/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 15396 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |