Organization
KSA YOUTH FOUNDATION INC.
Active
Other names
A t Counseling Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KATRINA ANN WILKINS-JACKSON (CEO/OWNER)
(240) 766-4194
Entity
Organization
Contact information
Practice address
10905 FORT WASHINGTON RD STE 105, FORT WASHINGTON, MD 20744-5844
(240) 766-4194
(301) 485-0363
Mailing address
10905 FORT WASHINGTON RD STE 105, FORT WASHINGTON, MD 20744-5844
(240) 766-4194
(301) 485-0363
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
DC
101YP2500X
Professional Counselor
—
MD
1041C0700X
Clinical Social Worker
—
MD
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
MD
Other
Enumeration date
03/03/2018
Last updated
10/03/2023
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