Organization
THE RESILIENT LIFE COUNSELING & WELLNESS CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY BRENTON MS, LCPC (CEO)
(443) 502-0471
Entity
Organization
Contact information
Practice address
2 E ROLLING CROSSROADS STE 157, CATONSVILLE, MD 21228-6213
(443) 502-0471
Mailing address
2 E ROLLING CROSSROADS STE 157, CATONSVILLE, MD 21228-6213
(443) 592-0471
(443) 276-2800
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
LC4717
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1033462627
NPI
MD
Enumeration date
08/27/2014
Last updated
08/27/2014
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