Provider Demographics
NPI:1487408951
Name:A LEAP OF FAITH COUNSELING, COACHING, AND CONSULTING
Entity type:Organization
Organization Name:A LEAP OF FAITH COUNSELING, COACHING, AND CONSULTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YOSHICA
Authorized Official - Middle Name:LASHEA
Authorized Official - Last Name:MCCULLOUGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-965-0159
Mailing Address - Street 1:10903 INDIAN HEAD HWY STE 502
Mailing Address - Street 2:
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20744-4012
Mailing Address - Country:US
Mailing Address - Phone:301-965-0159
Mailing Address - Fax:
Practice Address - Street 1:10903 INDIAN HEAD HWY STE 502
Practice Address - Street 2:
Practice Address - City:FORT WASHINGTON
Practice Address - State:MD
Practice Address - Zip Code:20744-4012
Practice Address - Country:US
Practice Address - Phone:013-965-0159
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-12
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty