Provider Demographics
NPI:1316690712
Name:CENTER FOR ACTUALIZED COUNSELING, LLC
Entity type:Organization
Organization Name:CENTER FOR ACTUALIZED COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRIMARY PSYCHOTHERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:BRADFORD
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:DREWNIAK
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:410-618-1641
Mailing Address - Street 1:31 OLD SOLOMONS ISLAND RD STE 201
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-3889
Mailing Address - Country:US
Mailing Address - Phone:410-618-1641
Mailing Address - Fax:
Practice Address - Street 1:317 OVERBROOK RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21212-1802
Practice Address - Country:US
Practice Address - Phone:410-940-9329
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-27
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty