Individual
MARIAN G UPTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC, CRC, CCDC
Contact information
Practice address
2480 LLEWELLYN AVE, FORT MEADE, MD 20755-7081
(301) 677-7981
Mailing address
2480 LLEWELLYN AVE, FORT MEADE, MD 20755-7081
(301) 677-7981
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
CRC # 00112609
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
4244
MD
101YP2500X
Professional Counselor
Primary
LPC-4988
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
UIN # VAD000
FEDERAL PROGRAM-TRICARE
MD
Enumeration date
07/23/2012
Last updated
07/23/2012
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