Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. JUSTIN DEITRICK, LGPC
ActiveMR. JUSTIN DEITRICK, LGPC is a Professional Counselor healthcare provider located in GLENWOOD, Maryland. NPI 1417660663 is currently active in the NPPES registry. Verify at CMS.
Professional Counselor · GLENWOOD, MD
Registration Details
- NPI Number
- 1417660663
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jan 3, 2023 (3.6365186971863 yrs)
- Last Updated
- Jan 3, 2023
- License
-
LGP1399 (MD)
Practice Information
- Address
-
3700 CHAMPIONSHIP DRGLENWOOD, MD, 217389311Browse MD providers · Browse ZIP 21738
- Phone
- 4434721349
- Primary Specialty
-
Professional Counselor
101YP2500X
- Additional Specialty
- Professional Counselor
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.