Organization
SAFE SPACE COUNSELING CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHANTEL COPELAND LICSW (CLINICIAN)
(813) 830-3261
Entity
Organization
Contact information
Practice address
2957 FESTIVAL WAY STE 123 #1014, WALDORF, MD 20601
(301) 245-1339
Mailing address
2957 FESTIVAL WAY STE 123 #1014, WALDORF, MD 20601
(301) 245-1339
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AY730004
CARE FIRST
DC
Enumeration date
04/08/2021
Last updated
04/08/2021
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