Organization
COLLABORATIVE CONCEPTS OF MARYLAND
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHIRLEY R. NEWTON-GUEST LCSW-C (LICENSED CERTIFIED SOCIAL WORKER-CL)
(301) 318-1148
Entity
Organization
Contact information
Practice address
1400 MERCANTILE LANE, SUITE 208, LARGO, MD 20774
(301) 318-1148
Mailing address
1400 MERCANTILE LANE, SUITE 208, LARGO, MD 20774
(301) 318-1148
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
062835200
—
MD
05
—
512512000
—
MD
Enumeration date
10/22/2018
Last updated
10/22/2018
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