Therapy @ 9811 Inc

LBN: Therapy @ 9811 Inc
Therapy @ 9811 Inc is an health care organization with primary practice located at 9811 Mallard Dr Suite 210/211, Laurel MD 20708-3143. The organization recently has only one registered license in Behavioral Health & Social Service Providers / Counselor, which is considered as the primary health care specialty. Therapy @ 9811 Inc can be contacted via phone (301) 525-3205, or through Somerville, Jaccqueline via phone (301) 525-3205.

Contact Information

Primary practice address
9811 Mallard Dr Suite 210/211 Laurel MD 20708-3143
Phone: (301) 525-3205
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Somerville, Jaccqueline PSY.D., LCPC
Phone: (301) 525-3205

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X LC2025 Maryland

Profile Details

NPI number 1376823823
LBN Legal business name Therapy @ 9811 Inc
DBA Doing business as
Authorized official Somerville, Jaccqueline PSY.D., LCPC
Entity Organization
Organization subpart 1 No
Enumeration date Aug 27th, 2011
Last updated Nov 1st, 2013 - about 11 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376823823 NPPES
Other ID NUMBER IS TAX ID MHN
Other 1875 MHN
MEDICAID 413473700 MHN
Other 676619 MHN
Other NO NUMBER ASSIGNED MHN
Other 676619 MHN
Other NO NUMBER ASSIGNED MHN
Other 01217038 MHN
Other 1875-0001 MHN
Other ID NUMBER IS AN NPI MHN
Other NO NUMBER ASSIGNED MHN
Other NO NUMBER ASSIGNED MHN
Other NO NUMBER ASSIGNED MHN
Other 55STJE MHN
Other 7695828 MHN

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