| Southern Maryland Counseling, Llc | |
|
1295 Hollidge Rd Lusby MD 20657-2682 | |
| (410) 231-2124 | |
| (410) 882-1079 |
| Full Name | Southern Maryland Counseling, Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 1295 Hollidge Rd, Lusby, Maryland |
| Authorized Official Name and Position | Diana Lynne Kraft (MANAGING MEMBER) |
| Authorized Official Contact | 4102312124 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern Maryland Counseling, Llc 1295 Hollidge Rd Lusby MD 20657-2682 Ph: (410) 231-2124 | Southern Maryland Counseling, Llc 1295 Hollidge Rd Lusby MD 20657-2682 Ph: (410) 231-2124 |
| NPI Number | 1477991594 |
|---|---|
| Provider Enumeration Date | 06/11/2013 |
| Last Update Date | 06/17/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477991594 | NPI | - | NPPES |
| 115605500 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | LC1273 (Maryland) | Primary |
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Southern Maryland Counseling, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1295 Hollidge Rd, Lusby, MD 20657 Phone: 410-231-2124 Fax: 410-882-1079 |