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Organization

SHIFTING MINDSETS COUNSELING AND CONSULTING

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MARCELLINA FUQUA LCSW-C (C.E.O)
(443) 497-8799
Entity
Organization

Contact information

Practice address
10530 CAMPUS WAY S # 1143, LARGO, MD 20774-1309
(443) 497-8799
Mailing address
3508 COMMUNITY DR, DISTRICT HEIGHTS, MD 20747-5902

Taxonomy

Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
1041C0700X
Clinical Social Worker
251S00000X
Community/Behavioral Health Agency

Other

Enumeration date
05/05/2022
Last updated
08/16/2022
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