Provider Demographics
NPI:1316669237
Name:CLIPPER COUNSELING LLC
Entity type:Organization
Organization Name:CLIPPER COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:EBONI
Authorized Official - Middle Name:
Authorized Official - Last Name:CLIPPER
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:240-413-3419
Mailing Address - Street 1:609 HIMES AVE APT 112
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21703-6204
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:609 HIMES AVE APT 112
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21703-6204
Practice Address - Country:US
Practice Address - Phone:240-413-3419
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-16
Last Update Date:2022-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty