| NPI | 1851954093 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: VA 0701010406) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MD LC13103) |
| 101YM0800X Counselor, Mental Health (Licence: WV 2789) | |
| 101YM0800X Counselor, Mental Health (Licence: MI 6401224596) | |
| 101YM0800X Counselor, Mental Health (Licence: CA 14784) | |
| 101YM0800X Counselor, Mental Health (Licence: NJ 37PC01086100) | |
| 101YM0800X Counselor, Mental Health (Licence: TX 89465) | |
| 101YM0800X Counselor, Mental Health (Licence: IL 180.016588) | |
| 101YM0800X Counselor, Mental Health (Licence: NM CTB-2023-0323) | |
| 101YM0800X Counselor, Mental Health (Licence: CT 5550) | |
| 101YM0800X Counselor, Mental Health (Licence: MA LMHC10003474) | |
| 101YM0800X Counselor, Mental Health (Licence: DE PC-011169) | |
| 101YM0800X Counselor, Mental Health (Licence: PA PC011223) | |
| Enumeration Date | 2019-04-14 |
| Last Update Date | 2026-03-11 |