Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | LC7365 | MD |
N | 101YM0800X | Mental Health Counselor | LC7365 | MD |
Y | 101YP2500X | Professional Counselor | LC7365 | MD |
NPI | 1003356619 |
---|---|
Provider Name | Mrs. Carrie Mead |
First Address | Westminster, MD 21157-7771 |
Second Address | Westminster, MD 21157-7771 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/03/2017 |
Last Update Date | 01/03/2017 |