| Cloverleaf Counseling Services, LLC | |
|
6790 Crain Hwy La Plata MD 20646-4950 | |
| (301) 542-6800 | |
| Not Available |
| Full Name | Cloverleaf Counseling Services, LLC |
|---|---|
| Speciality | Clinic/Center |
| Location | 6790 Crain Hwy, La Plata, Maryland |
| Authorized Official Name and Position | Ann Patricia Inniss (OWNER) |
| Authorized Official Contact | 3015426800 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cloverleaf Counseling Services, LLC 816 Washington Ave La Plata MD 20646-9470 Ph: (301) 542-6800 | Cloverleaf Counseling Services, LLC 6790 Crain Hwy La Plata MD 20646-4950 Ph: (301) 542-6800 |
| NPI Number | 1518613975 |
|---|---|
| Provider Enumeration Date | 02/24/2022 |
| Last Update Date | 02/24/2022 |
| Certification Date | 02/24/2022 |
| Medicare PECOS PAC ID | 8527598317 |
|---|---|
| Medicare Enrollment ID | O20250210000183 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518613975 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (NU) | Primary |
| Provider Name | Ann Patricia Inniss |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1437799533 PECOS PAC ID: 9436689221 Enrollment ID: I20250210000228 |
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