Organization
MD COUNSELING SERVICES-OMHC CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR LISA M GRESHAM-WILSON PHD, LMSW, LCPC (CEO)
(443) 885-9406
Entity
Organization
Contact information
Practice address
924 E BALTIMORE ST STE 204, BALTIMORE, MD 21202-4736
(443) 885-9406
Mailing address
900 E FAYETTE ST UNIT 23495, BALTIMORE, MD 21203-7688
(443) 885-9406
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
11/20/2020
Last updated
11/20/2020
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