Organization
PRODIGY COUNSELING SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ASIA RAY LCPC (MENTAL HEALTH THERAPIST)
(443) 577-8959
Entity
Organization
Contact information
Practice address
17 WARREN RD, PIKESVILLE, MD 21208-5334
(443) 577-8959
Mailing address
8718 GILLY WAY, RANDALLSTOWN, MD 21133-5310
(443) 577-8959
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
262005700
—
MD
Enumeration date
12/20/2018
Last updated
12/20/2018
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