# C. O. A. C. H. MENTAL HEALTH, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1265771646
- **Authorized official:** DWAYNE GREEN LCPC (OWNER)
- **Authorized official phone:** (443) 506-6313

## Contact information

- **Practice address:** 5 SHAWAN RD STE 101C, HUNT VALLEY, MD 21030-1373
- **Practice address phone:** (443) 982-0692
- **Practice address fax:** (443) 982-0610
- **Mailing address:** 5 SHAWAN RD STE 101C, HUNT VALLEY, MD 21030-1373
- **Mailing address phone:** (443) 982-0692
- **Mailing address fax:** (443) 982-0610

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | LC3757 | MD | Yes |

## Other

- **Enumeration date:** 02/05/2013
- **Last updated:** 02/25/2019