Organization
OLIVE BRANCH COUNSELING SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN POLANCO LCPC (OWNER)
(443) 331-5959
Entity
Organization
Contact information
Practice address
6805 BARNETT RD, BALTIMORE, MD 21239-1215
(443) 331-5949
Mailing address
6805 BARNETT RD, BALTIMORE, MD 21239-1215
(443) 331-5949
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
12/21/2020
Last updated
08/07/2024
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