Organization
WATERSHED COUNSELING SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KAREN E RAY PH.D., LCPC (DIRECTOR)
(443) 486-4848
Entity
Organization
Contact information
Practice address
246 MERRIMAC COURT, PRINCE FREDERICK, MD 20678-0453
(443) 486-4848
Mailing address
PO BOX 453, PRINCE FREDERICK, MD 20678-0453
(443) 486-4848
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LC3657
MD
1041C0700X
Clinical Social Worker
11812
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
D298254
—
MD
Enumeration date
04/26/2016
Last updated
04/26/2016
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