| Lantern Therapeutic Services | |
|
11680 Doolittle Dr Ste 111 Waldorf MD 20602-3802 | |
| (240) 607-2756 | |
| (240) 607-2776 |
| Full Name | Lantern Therapeutic Services |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 11680 Doolittle Dr Ste 111, Waldorf, Maryland |
| Authorized Official Name and Position | Karen Jones (CEO) |
| Authorized Official Contact | 3013968404 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lantern Therapeutic Services 1282 Smallwood Dr W Suite 507 Waldorf MD 20603-4732 Ph: (240) 607-2756 | Lantern Therapeutic Services 11680 Doolittle Dr Ste 111 Waldorf MD 20602-3802 Ph: (240) 607-2756 |
| NPI Number | 1942529920 |
|---|---|
| Provider Enumeration Date | 05/29/2010 |
| Last Update Date | 10/05/2023 |
| Certification Date | 10/03/2023 |
| Medicare PECOS PAC ID | 8820348238 |
|---|---|
| Medicare Enrollment ID | O20180906000079 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942529920 | NPI | - | NPPES |
| 422505800 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Tanya N Alim |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1972601763 PECOS PAC ID: 1557529013 Enrollment ID: I20180906000438 |
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