Provider Demographics
NPI:1194263467
Name:LFW CLINICAL, COUNSELING & COMMUNITY CONSULTING, LLC
Entity type:Organization
Organization Name:LFW CLINICAL, COUNSELING & COMMUNITY CONSULTING, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/CEO; LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LA TOYA
Authorized Official - Middle Name:BIANCA
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:410-989-3558
Mailing Address - Street 1:21 WEST RD
Mailing Address - Street 2:150
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-2325
Mailing Address - Country:US
Mailing Address - Phone:410-989-3558
Mailing Address - Fax:
Practice Address - Street 1:21 WEST RD
Practice Address - Street 2:150
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-2325
Practice Address - Country:US
Practice Address - Phone:410-989-3558
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-07
Last Update Date:2017-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD05744251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health