| Community Therapeutic Services, Llc | |
|
4409 Forbes Blvd Ste B Lanham MD 20706-4373 | |
| (301) 399-7811 | |
| (301) 358-6455 |
| Full Name | Community Therapeutic Services, Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 4409 Forbes Blvd Ste B, Lanham, Maryland |
| Authorized Official Name and Position | Jenita Charmain Griffin (PSYCHOLOGIST) |
| Authorized Official Contact | 3013997811 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Therapeutic Services, Llc 5204 Derby Manor Ln Upper Marlboro MD 20772-2996 Ph: (301) 399-7811 | Community Therapeutic Services, Llc 4409 Forbes Blvd Ste B Lanham MD 20706-4373 Ph: (301) 399-7811 |
| NPI Number | 1639597859 |
|---|---|
| Provider Enumeration Date | 04/04/2014 |
| Last Update Date | 07/26/2017 |
| Medicare PECOS PAC ID | 6406211135 |
|---|---|
| Medicare Enrollment ID | O20230502000296 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639597859 | NPI | - | NPPES |
| 523110801 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 5323 (Maryland) | Primary |
| Provider Name | Jenita Charmain Griffin |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1790725356 PECOS PAC ID: 8820215205 Enrollment ID: I20230502000373 |
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