Provider Demographics
NPI:1538730866
Name:INTENTIONAL COUNSELING AND WELLNESS, LLC
Entity type:Organization
Organization Name:INTENTIONAL COUNSELING AND WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ANAMARIA
Authorized Official - Middle Name:DIANA
Authorized Official - Last Name:BARABAS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-C
Authorized Official - Phone:443-856-9231
Mailing Address - Street 1:5909 DUNDEE DR
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21804-1492
Mailing Address - Country:US
Mailing Address - Phone:443-856-9231
Mailing Address - Fax:
Practice Address - Street 1:5909 DUNDEE DR
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21804-1492
Practice Address - Country:US
Practice Address - Phone:443-856-9231
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-07
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)