| Sw Therapeutic Services, Inc. | |
|
17203 Clairfield Ln Upper Marlboro MD 20772-3335 | |
| (301) 627-0568 | |
| (301) 780-5322 |
| Full Name | Sw Therapeutic Services, Inc. |
|---|---|
| Speciality | Counselor - Professional |
| Location | 17203 Clairfield Ln, Upper Marlboro, Maryland |
| Authorized Official Name and Position | Shannon Renee Williams (PRESIDENT) |
| Authorized Official Contact | 3016270568 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sw Therapeutic Services, Inc. 17203 Clairfield Ln Upper Marlboro MD 20772-3335 Ph: (301) 627-0568 | Sw Therapeutic Services, Inc. 17203 Clairfield Ln Upper Marlboro MD 20772-3335 Ph: (301) 627-0568 |
| NPI Number | 1770637647 |
|---|---|
| Provider Enumeration Date | 01/22/2007 |
| Last Update Date | 06/24/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770637647 | NPI | - | NPPES |
| 013226800 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | LC1245 (Maryland) | Secondary |
| 101YP2500X | Counselor - Professional | LC1245 (Maryland) | Primary |
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