| Basics Group Practice, Llc | |
|
7610 Pennsylvania Ave Suite #203 Forestville MD 20747-4701 | |
| (301) 420-1972 | |
| (301) 420-1973 |
| Full Name | Basics Group Practice, Llc |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 7610 Pennsylvania Ave, Forestville, Maryland |
| Authorized Official Name and Position | Daniel N Ferebee (CEO) |
| Authorized Official Contact | 3014201972 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Basics Group Practice, Llc 7610 Pennsylvania Ave Suite #203 Forestville MD 20747-4701 Ph: () - | Basics Group Practice, Llc 7610 Pennsylvania Ave Suite #203 Forestville MD 20747-4701 Ph: (301) 420-1972 |
| NPI Number | 1134486079 |
|---|---|
| Provider Enumeration Date | 04/17/2012 |
| Last Update Date | 04/17/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134486079 | NPI | - | NPPES |
| 417682100 | Medicaid | MD | |
| 036596300 | Medicaid | MD | |
| 417682101 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 04481 (Maryland) | Primary |
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