| Real Life Counseling Llc | |
|
21-25 E Ellendale Street Suite B, 2nd Floor Bel Air MD 21014-2924 | |
| (443) 655-7164 | |
| Not Available |
| Full Name | Real Life Counseling Llc |
|---|---|
| Speciality | Counselor |
| Location | 21-25 E Ellendale Street, Bel Air, Maryland |
| Authorized Official Name and Position | Linda Louise Smith (CLINICAL SUPERVISOR) |
| Authorized Official Contact | 4436557164 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Real Life Counseling Llc Po Box 837 Forest Hill MD 21050-0837 Ph: (443) 655-7164 | Real Life Counseling Llc 21-25 E Ellendale Street Suite B, 2nd Floor Bel Air MD 21014-2924 Ph: (443) 655-7164 |
| NPI Number | 1205282449 |
|---|---|
| Provider Enumeration Date | 05/06/2016 |
| Last Update Date | 05/27/2016 |
| Medicare PECOS PAC ID | 4789964289 |
|---|---|
| Medicare Enrollment ID | O20161129000494 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205282449 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | LC1174 (Maryland) | Primary |
| Provider Name | Kimberly J Jordan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285009548 PECOS PAC ID: 3577843077 Enrollment ID: I20161129000623 |
| Provider Name | Hannah L Ansaldi |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1144843400 PECOS PAC ID: 0749638583 Enrollment ID: I20231204003559 |
| Provider Name | Melissa A Nein |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1144281726 PECOS PAC ID: 7315999455 Enrollment ID: I20231205000749 |
| Provider Name | Thomas Whiteleather |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1154774834 PECOS PAC ID: 1951681451 Enrollment ID: I20231207001996 |
| Provider Name | Linda L Smith |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1417065202 PECOS PAC ID: 7214217710 Enrollment ID: I20231207003358 |
| Provider Name | Jessica P Miller |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1154074631 PECOS PAC ID: 6103262076 Enrollment ID: I20240313003988 |
| Provider Name | Deanna A Wnek |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1316640311 PECOS PAC ID: 7911431176 Enrollment ID: I20241111001207 |
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