Provider Demographics
NPI:1316146566
Name:MARYLAND COUNSELING CENTERS, INC.
Entity type:Organization
Organization Name:MARYLAND COUNSELING CENTERS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FREDERICK
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:OELTJEN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:301-424-6955
Mailing Address - Street 1:5300 WESTVIEW DR.
Mailing Address - Street 2:BLDG. 100, SUITE 104
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21703-9063
Mailing Address - Country:US
Mailing Address - Phone:310-662-0855
Mailing Address - Fax:301-662-6261
Practice Address - Street 1:5300 WESTVIEW DR.
Practice Address - Street 2:BLDG. 100, SUITE 104
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21703-8327
Practice Address - Country:US
Practice Address - Phone:310-662-0855
Practice Address - Fax:301-662-6261
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-17
Last Update Date:2015-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty