Provider Demographics
NPI:1366170003
Name:GREY MATTER COUNSELING & CONSULTING, LLC
Entity type:Organization
Organization Name:GREY MATTER COUNSELING & CONSULTING, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSADO
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC, NCC, MBA
Authorized Official - Phone:443-720-6008
Mailing Address - Street 1:3 CANVAS PL
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21015-8613
Mailing Address - Country:US
Mailing Address - Phone:914-469-9073
Mailing Address - Fax:
Practice Address - Street 1:221 MAITLAND ST STE 200
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-3930
Practice Address - Country:US
Practice Address - Phone:443-720-6008
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-10
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Multi-Specialty