Organization · NPI-2

Ultramarine Counseling & Art Therapy

Marriage & Family Therapist · Annapolis, MD

NPI number1912576497

StatusActive

Last updated in NPPESJun 27, 2021

Details

NPI: 1912576497
Entity type: Organization (NPI-2)
Legal business name: Ultramarine Counseling & Art Therapy
Organization subpart: No
Enumeration date: Jun 21, 2021
Certification date: Jun 27, 2021
Last updated: Jun 27, 2021

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
106H00000X	Marriage & Family Therapist	–	–	Yes
101YM0800X	Counselor, Mental Health	–	–
101YP2500X	Counselor, Professional	–	–
104100000X	Social Worker	–	–
1041C0700X	Social Worker, Clinical	–	–

Practice location

1835 Forest Dr Ste H
Annapolis, MD 21401-4432

Phone 410-294-9324

Mailing address

1835 Forest Dr Ste H
Annapolis, MD 21401-4432

Phone 410-294-9324

Authorized official

Jessica Heckwolf
Owner
4102949324

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