Organization Name: | RESTORATION COUNSELING, LLC |
NPI Number: | 1134501836 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KRYSTAL LASHON SMITH (LICENSED CLINICAL SOCIAL WORKER) |
Mailing Address: | 2 W Rolling Suite 210 Catonsville |
State: | MD US |
Postal Code: | 212286208 |
Phone Number: | 4107447014 |
Fax Number: | 4107446903 |
NPI Enumeration Date: | 06/18/2015 |
NPI Last Update Date: | 06/18/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QM0850X |
License Number: | 15128 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MD |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Adult Mental Health |
Taxonomy Definition: | An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |