Organization
PHAZE COUNSELING SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNTEL MONIQUE GLADNEY LCPC (OWNER)
(443) 622-8755
Entity
Organization
Contact information
Practice address
4425 FITCH AVE STE 118, NOTTINGHAM, MD 21236-3927
(410) 870-2125
Mailing address
4425 FITCH AVE STE 118, NOTTINGHAM, MD 21236-3927
(410) 870-2125
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
08/14/2020
Last updated
08/14/2020
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