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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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