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Organization
C. O. A. C. H. MENTAL HEALTH, LLC
Active
Organization
C. O. A. C. H. MENTAL HEALTH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DWAYNE GREEN LCPC (OWNER)
(443) 506-6313
Entity
Organization
Contact information
Practice address
5 SHAWAN RD STE 101C, HUNT VALLEY, MD 21030-1373
(443) 982-0692
(443) 982-0610
Mailing address
5 SHAWAN RD STE 101C, HUNT VALLEY, MD 21030-1373
(443) 982-0692
(443) 982-0610
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LC3757
MD
Other
Enumeration date
02/05/2013
Last updated
02/25/2019
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