Organization
CORDILLERA COUNSELING SERVICES LLC
Active
Parent organization
CORDILLERA COUNSELING SERVICES LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
CORDILLERA COUNSELING SERVICES LLC
Authorized official
TAHMINEH ANN SHADKHOO LCPC (LICENSED PROFESSIONAL COUNSELOR)
(443) 745-2363
Entity
Organization
Contact information
Practice address
5570 STERRETT PLACE, COLUMBIA, MD 21044-2649
(443) 203-9838
Mailing address
3319 GOVERNOR CARROLL CT, ELLICOTT CITY, MD 21043-3456
(443) 745-2363
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
08/08/2023
Last updated
08/08/2023
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