Organization
PHAZE COUNSELING SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNTEL MONIQUE GLADNEY (CEO)
(443) 622-8755
Entity
Organization
Contact information
Practice address
8007 CORPORATE DR STE A, NOTTINGHAM, MD 21236-4905
(410) 874-9595
Mailing address
8007 CORPORATE DR STE A, NOTTINGHAM, MD 21236-4905
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
11/13/2023
Last updated
11/13/2023
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