| Potomac Cbt Center | |
|
12712 Deep Spring Dr Potomac MD 20854-2355 | |
| (240) 200-0842 | |
| (301) 590-0758 |
| Full Name | Potomac Cbt Center |
|---|---|
| Speciality | Psychologist |
| Location | 12712 Deep Spring Dr, Potomac, Maryland |
| Authorized Official Name and Position | Maria Jose Rendon (CLINICAL DIRECTOR) |
| Authorized Official Contact | 2402000842 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Potomac Cbt Center 402 King Farm Blvd Suite 125, #1102 Rockville MD 20850 Ph: (786) 281-4742 | Potomac Cbt Center 12712 Deep Spring Dr Potomac MD 20854-2355 Ph: (240) 200-0842 |
| NPI Number | 1275266058 |
|---|---|
| Provider Enumeration Date | 07/08/2022 |
| Last Update Date | 10/31/2022 |
| Certification Date | 10/31/2022 |
| Medicare PECOS PAC ID | 3870958747 |
|---|---|
| Medicare Enrollment ID | O20230427002147 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275266058 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC1900X | Psychologist - Counseling | (* (Not Available)) | Primary |
| Provider Name | Maria Jose Rendon |
|---|---|
| Provider Type | Practitioner - Psychologist Billing Independently |
| Provider Identifiers | NPI Number: 1023556065 PECOS PAC ID: 4385921287 Enrollment ID: I20230427002544 |
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