Organization
CREDIBLECARE SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DERICK SONJONG (PRESIDENT)
(571) 277-0779
Entity
Organization
Contact information
Practice address
4507 LYONS CIR, APT T3, OWINGS MILLS, MD 21117-6979
(571) 277-0779
Mailing address
4507 LYONS RUN CIR APT T3, OWINGS MILLS, MD 21117-6979
(571) 277-0779
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
07/24/2024
Last updated
07/24/2024
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