| Therapy @ 9811 Inc | |
|
9811 Mallard Dr Suite 210/211 Laurel MD 20708-3143 | |
| (301) 525-3205 | |
| Not Available |
| Full Name | Therapy @ 9811 Inc |
|---|---|
| Speciality | Counselor |
| Location | 9811 Mallard Dr, Laurel, Maryland |
| Authorized Official Name and Position | Jaccqueline Somerville (OWNER/ CEO) |
| Authorized Official Contact | 3015253205 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Therapy @ 9811 Inc 6996 Hanover Pkwy Apt 202 Greenbelt MD 20770-2244 Ph: (443) 852-2641 | Therapy @ 9811 Inc 9811 Mallard Dr Suite 210/211 Laurel MD 20708-3143 Ph: (301) 525-3205 |
| NPI Number | 1376823823 |
|---|---|
| Provider Enumeration Date | 08/27/2011 |
| Last Update Date | 11/01/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376823823 | NPI | - | NPPES |
| ID NUMBER IS TAX ID | Other | MHN | |
| 1875 | Other | CAREFIRST BLUE CROSS BLUE SHIELD | |
| 413473700 | Medicaid | MD | |
| 676619 | Other | VALUE OPTIONS | |
| NO NUMBER ASSIGNED | Other | CORPHEALTH | |
| 676619 | Other | UNITED BEHAVIORAL HEALTH | |
| NO NUMBER ASSIGNED | Other | CERIDIAN EAP | |
| 01217038 | Other | AMERIGROUP MEDICAID | |
| 1875-0001 | Other | CAREFIST FEP | |
| ID NUMBER IS AN NPI | Other | TRICARE | |
| NO NUMBER ASSIGNED | Other | FIRST ADVANTAGE EAP | |
| NO NUMBER ASSIGNED | Other | CAREBRIDGE EAP | |
| NO NUMBER ASSIGNED | Other | INOVA EAP | |
| 55STJE | Other | CAREFIRST OF MARYLAND | |
| 7695828 | Other | AETNA (MHMO, MPPO, MEPO, MCPPO, EAP) |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | LC2025 (Maryland) | Primary |
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