| Organization Name: | EXCELLIS CONSULTING AND CLINICAL SERVICES, LLC |
| NPI Number: | 1184042616 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MICHAEL PATRICK MALONE (CEO) |
| Mailing Address: | 10632 Little Patuxent Pkwy Suite 310 Columbia |
| State: | MD US |
| Postal Code: | 210443273 |
| Phone Number: | 2405479462 |
| Fax Number: | |
| NPI Enumeration Date: | 04/02/2014 |
| NPI Last Update Date: | 04/02/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101Y00000X |
| License Number: | LC2181 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |