Organization
SPACE BETWEEN COUNSELING SERVICES, LLC
Active
Parent organization
SPACE BETWEEN COUNSELING SERVICES, LLC
Other names
Space Between Counseling Service, LLC, Space BetweenCounseling Services, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
SPACE BETWEEN COUNSELING SERVICES, LLC
Authorized official
MRS. SUSAN MORGAN STORK LCPC (FOUNDER)
(443) 527-2042
Entity
Organization
Contact information
Practice address
1501 SULGRAVE AVE STE 200A, BALTIMORE, MD 21209-4595
(443) 527-2042
Mailing address
1501 SULGRAVE AVE STE 200A, BALTIMORE, MD 21209-4595
(443) 527-2042
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1952785586
COUNSELING / THERAPY / MENTAL HEALTH
MD
Enumeration date
08/07/2019
Last updated
08/07/2019
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