Organization
INTEGRATIVE CLINICAL COUNSELING SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YVONNE DENISE LOFTIN-WOODARD LCSW-C (CEO)
(410) 371-4448
Entity
Organization
Contact information
Practice address
3224 HALCYON CT, ELLICOTT CITY, MD 21043-3379
(410) 371-4448
Mailing address
3224 HALCYON CT, ELLICOTT CITY, MD 21043-3379
(410) 371-4448
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
08/16/2021
Last updated
08/16/2021
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