# ULTRAMARINE COUNSELING & ART THERAPY

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

## Provider details

- **NPI number:** 1912576497
- **Authorized official:** JESSICA HECKWOLF LCMFT, LCPAT (OWNER)
- **Authorized official phone:** (410) 294-9324

## Contact information

- **Practice address:** 1835 FOREST DR STE H, ANNAPOLIS, MD 21401-4432
- **Practice address phone:** (410) 294-9324
- **Mailing address:** 1835 FOREST DR STE H, ANNAPOLIS, MD 21401-4432
- **Mailing address phone:** (410) 294-9324

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | — |
| 101YM0800X | Mental Health Counselor | — | — | — |
| 101YP2500X | Professional Counselor | — | NULL | — |
| 101YP2500X | Professional Counselor | — | — | — |
| 104100000X | Social Worker | — | NULL | — |
| 104100000X | Social Worker | — | — | — |
| 1041C0700X | Clinical Social Worker | — | NULL | — |
| 1041C0700X | Clinical Social Worker | — | — | — |
| 106H00000X | Marriage & Family Therapist | — | NULL | Yes |
| 106H00000X | Marriage & Family Therapist | — | — | Yes |

## Other

- **Enumeration date:** 06/21/2021
- **Last updated:** 06/27/2021