| Takoma Therapy, Llc | |
|
6930 Carroll Ave Ste 830 Takoma Park MD 20912-4461 | |
| (301) 802-5653 | |
| Not Available |
| Full Name | Takoma Therapy, Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 6930 Carroll Ave Ste 830, Takoma Park, Maryland |
| Authorized Official Name and Position | Simone Jacobs (OWNER) |
| Authorized Official Contact | 3018025653 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Takoma Therapy, Llc 6930 Carroll Ave Ste 830 Takoma Park MD 20912-4461 Ph: (301) 802-5653 | Takoma Therapy, Llc 6930 Carroll Ave Ste 830 Takoma Park MD 20912-4461 Ph: (301) 802-5653 |
| NPI Number | 1285135277 |
|---|---|
| Provider Enumeration Date | 02/24/2018 |
| Last Update Date | 04/23/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285135277 | NPI | - | NPPES |
| 416691400 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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