| Doctor Name: | DR. RODERICK IRVING WELLINGTON |
| NPI Number: | 1336535319 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LCPC, NCC, CFC |
| License Number: | LC6249 |
| Business Practice Address: | 7050 Chesapeake Rd Suite 104 Landover Hills, MD - 207842347 |
| Business Phone Number: | 3014590726 |
| Business Fax Number: | 3015763787 |
| Mailing Address: | 7050 Chesapeake Rd, Suite 104 LANDOVER HILLS |
| State: | MD |
| Postal Code: | 207842347 |
| Phone Number: | 3014590726 |
| Fax Number: | 3015763787 |
| NPI Enumeration Date: | 04/07/2015 |
| NPI Last Update Date: | 04/07/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC2200X |
| License Number: | LC6249 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical Child & Adolescent |
| Taxonomy Definition: | |