| Edward L. Mislak, Llc | |
| 
					801 Chance Ct Street MD 21154-1648  | |
| (410) 893-7217 | |
| (410) 893-7217 | 
| Full Name | Edward L. Mislak, Llc | 
|---|---|
| Speciality | Social Worker - Clinical | 
| Location | 801 Chance Ct, Street, Maryland | 
| Authorized Official Name and Position | Edward Leo Mislak (CLINICAL SOCIAL WORKER) | 
| Authorized Official Contact | 4108937217 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Edward L. Mislak, Llc 801 Chance Ct Street MD 21154-1648 Ph: (410) 893-7217  | Edward L. Mislak, Llc 801 Chance Ct Street MD 21154-1648 Ph: (410) 893-7217  | 
| NPI Number | 1154667988 | 
|---|---|
| Provider Enumeration Date | 12/26/2012 | 
| Last Update Date | 12/27/2017 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1154667988 | NPI | - | NPPES | 
| 031101400 | Medicaid | MD | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 08156 (Maryland) | Primary | 
Harford County Counseling Services, Llc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 801 Chance Ct, Street, MD 21154 Phone: 410-893-7217  |