Nicholas A Etheridge, LCPC, NCC
Counselor, Professional in Baltimore, MD. Individual provider (NPI-1).
NPI number1003374752
StatusActive
Last updated in NPPESMay 24, 2021
Details
- NPI
- 1003374752
- Entity type
- Individual (NPI-1)
- Name
- Nicholas A Etheridge
- Credential
- LCPC, NCC
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 12, 2019
- Certification date
- May 24, 2021
- Last updated
- May 24, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YP2500X | Counselor, Professional | LC11427 | MD | Yes |
Practice location
5500 Harford Rd Ste 201Baltimore, MD 21214-2290
Phone 667-706-9091
Mailing address
5500 Harford Rd Ste 201Baltimore, MD 21214-2290
Phone 667-706-9091
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