Organization
SUBURBAN PASTORAL COUNSLEING CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELAINE M BAIN PH.D.; LCPC (EXECUTIVE /CLINICAL DIRECTOR)
(410) 719-0086
Entity
Organization
Contact information
Practice address
2 W. ROLLING CROSSROADS STE 209, CATONSVILLE, MD 21228-6209
(410) 719-0086
(443) 251-2664
Mailing address
PO BOX 3274, CATONSVILLE, MD 21228-0274
(410) 719-0086
(443) 251-2664
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LC6983
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LC6983
LICENSED PROFESSIONAL CLINICAL COUNSELOR
MD
Enumeration date
05/11/2016
Last updated
05/11/2016
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