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Organization

AUTHENTIC CONNECTIONS THERAPEUTIC SERVICES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KYANA BRADLEY LPC, LCPC (PRESIDENT)
(202) 344-7933
Entity
Organization

Contact information

Practice address
8101 SANDY SPRING RD STE 250, LAUREL, MD 20707-3527
(202) 344-7933
(240) 366-5750
Mailing address
9783 MOUNTAIN LAUREL WAY APT 2C, LAUREL, MD 20723-6334
(202) 344-7933
(240) 366-5750

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
101YM0800X
Mental Health Counselor
Primary
101YP2500X
Professional Counselor

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
907084200
MD
Enumeration date
10/15/2018
Last updated
06/11/2019
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