Provider Demographics
NPI:1528769874
Name:GOOD COUNSEL COMMUNITY HEALTH CARE SERVICES LLC
Entity type:Organization
Organization Name:GOOD COUNSEL COMMUNITY HEALTH CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:BONIFACE
Authorized Official - Middle Name:A
Authorized Official - Last Name:ONAKINOR
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC, LCADC
Authorized Official - Phone:443-514-9141
Mailing Address - Street 1:11 ELWELL CT
Mailing Address - Street 2:
Mailing Address - City:RANDALLSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21133-4307
Mailing Address - Country:US
Mailing Address - Phone:443-514-9141
Mailing Address - Fax:
Practice Address - Street 1:11 ELWELL CT
Practice Address - Street 2:
Practice Address - City:RANDALLSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21133-4307
Practice Address - Country:US
Practice Address - Phone:443-514-9141
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-14
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty