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Organization

MORDECAI ANDEMICHAEL LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MORDECAI ANDEMICHAEL (THERAPIST)
(240) 476-2629
Entity
Organization

Contact information

Practice address
4413 REAMY DR, SUITLAND, MD 20746-3745
(301) 244-9131
Mailing address
4413 REAMY DR, SUITLAND, MD 20746-3745

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
101YA0400X
Addiction (Substance Use Disorder) Counselor
101YM0800X
Mental Health Counselor
101YP2500X
Professional Counselor

Other

Enumeration date
08/30/2021
Last updated
08/30/2021
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