Organization
POSITIVE CHALLENGES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. REGINALD DAVID BURGESS LCPC, LCADC (MENTAL HEALTH THERAPIST)
(443) 326-2499
Entity
Organization
Contact information
Practice address
100 WEST RD, SUITE 300, BALTIMORE, MD 21204-2331
(443) 326-2499
Mailing address
100 WEST RD, SUITE 300, BALTIMORE, MD 21204-2331
(443) 326-2499
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LC2419
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
418192100
—
MD
Enumeration date
10/07/2009
Last updated
11/02/2012
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