| NPI | 1861855983 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: VA 0701006450) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MD LC15955) |
| 101YP2500X Counselor, Professional (Licence: MA LMHC10000721) | |
| 101Y00000X Counselor (Licence: AZ LPC-22692) | |
| 101Y00000X Counselor (Licence: PA PC020042) | |
| 101Y00000X Counselor (Licence: GA LPC013157) | |
| 101Y00000X Counselor (Licence: CT 9063) | |
| 101Y00000X Counselor (Licence: TX 93412) | |
| 101Y00000X Counselor (Licence: WI 12326-125) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VA 0710101930) | |
| 101Y00000X Counselor (Licence: OH E.2505712) | |
| 101YP2500X Counselor, Professional (Licence: DC PRC200001993) | |
| 101Y00000X Counselor (Licence: MN 5487) | |
| 101Y00000X Counselor (Licence: SC 9225) | |
| 101Y00000X Counselor (Licence: NJ 37PC01030000) | |
| Enumeration Date | 2016-04-05 |
| Last Update Date | 2026-03-18 |