Provider Demographics
NPI:1861221657
Name:DRUMMOND, CIANNE A (LGPC)
Entity type:Individual
Prefix:
First Name:CIANNE
Middle Name:A
Last Name:DRUMMOND
Suffix:
Gender:F
Credentials:LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2005 BRODICK LN
Mailing Address - Street 2:
Mailing Address - City:GAMBRILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21054-1068
Mailing Address - Country:US
Mailing Address - Phone:240-565-4695
Mailing Address - Fax:
Practice Address - Street 1:3448 ELLICOTT CENTER DR STE 105
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21043-4668
Practice Address - Country:US
Practice Address - Phone:301-360-4349
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-30
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLG15339101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health