Symone Colquitt
Individual provider Active NPI Marriage & Family Therapist · College Park, MD
NPI 1578083630 · NPPES record last updated Jun 20, 2017
Key facts
- NPI
- 1578083630
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- LMC402 (MD)
- Practice address
- 7309 Baltimore Ave Ste 117
College Park, MD 20740-3200 - Phone
- (301) 213-1755
- NPI assigned
- Jun 20, 2017
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LMC402 | MD | MD | Marriage & Family Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | LMC402 | MD | Yes |
Addresses
Primary practice location
7309 Baltimore Ave Ste 117
College Park, MD 20740-3200
Mailing address
1805 Crosby Rd
Hyattsville, MD 20783-2918
Phone (301) 422-6779
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- Comptroller of Maryland Central Payroll Bureau
All providers in College Park, MD · Marriage & Family Therapist in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 20, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.