Provider Demographics
NPI:1285440990
Name:BENEFICENCE CENTER FOR COUNSELING LLC
Entity type:Organization
Organization Name:BENEFICENCE CENTER FOR COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHAE
Authorized Official - Middle Name:R
Authorized Official - Last Name:TRAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:240-906-1082
Mailing Address - Street 1:120 WATERFRONT ST #2300
Mailing Address - Street 2:STE 420
Mailing Address - City:NATIONAL HARBOR
Mailing Address - State:MD
Mailing Address - Zip Code:20745-1122
Mailing Address - Country:US
Mailing Address - Phone:240-906-1082
Mailing Address - Fax:240-712-5655
Practice Address - Street 1:120 WATERFRONT ST #2300
Practice Address - Street 2:STE 420
Practice Address - City:NATIONAL HARBOR
Practice Address - State:MD
Practice Address - Zip Code:20745-1122
Practice Address - Country:US
Practice Address - Phone:240-906-1082
Practice Address - Fax:240-712-5655
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-06
Last Update Date:2024-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No251S00000XAgenciesCommunity/Behavioral Health