Organization
1 AXIUM, LLC
Active
Other names
1st Axium, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GWENDOLYN LOVE KIMBROUGH PHD (CEO)
(202) 808-2878
Entity
Organization
Contact information
Practice address
4041 POWDER MILL RD STE 300, BELTSVILLE, MD 20705-3106
(202) 808-2878
(202) 506-2754
Mailing address
4041 POWDER MILL RD STE 300, BELTSVILLE, MD 20705-0004
(202) 808-2878
(202) 506-2754
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
103K00000X
Behavior Analyst
—
—
103TC0700X
Clinical Psychologist
—
—
103TP2701X
Group Psychotherapy Psychologist
—
—
103TR0400X
Rehabilitation Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
251B00000X
Case Management Agency
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251E00000X
Home Health Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
385H00000X
Respite Care
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
018287987
—
DC
Enumeration date
05/20/2016
Last updated
11/05/2024
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