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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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