Organization
VINCENT COUNSELING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TARA M WOODARD (OFFICE MANAGER)
(667) 200-7175
Entity
Organization
Contact information
Practice address
7519 HAINES CT, LAUREL, MD 20707-3345
(443) 303-9205
Mailing address
7519 HAINES CT, LAUREL, MD 20707-3345
(443) 303-9205
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
PRC11
DC
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCA139
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
905028
—
MD
Enumeration date
02/11/2017
Last updated
02/11/2017
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