Organization
URBAN TRAUMA COUNSELING CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHINELLE OGLESBY LCPC (CEO/CLINICAL DIRECTOR)
(410) 844-0770
Entity
Organization
Contact information
Practice address
3100 LORD BALTIMORE DR STE 110, WINDSOR MILL, MD 21244-5804
(410) 844-0770
Mailing address
3709 ESSEX RD, PIKESVILLE, MD 21207-4617
(410) 960-2496
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
05/31/2023
Last updated
05/31/2023
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