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Organization

CONNECTED SELF, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. MERLINA ALYCE PERKOWSKI LCMFT (OWNER, SOLE THERAPIST)
(301) 218-0836
Entity
Organization

Contact information

Practice address
3012 MITCHELLVILLE RD, SUITE 103, BOWIE, MD 20716-3986
(301) 218-0836
(301) 218-0836
Mailing address
3012 MITCHELLVILLE RD, SUITE 103, BOWIE, MD 20716-3986
(301) 218-0836
(301) 218-0836

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
LCM130
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
361133
MHN
MD
05
511509400
MD
Enumeration date
11/13/2006
Last updated
03/10/2014
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