| Waverly Center For Psychotherapy, Llc | |
|
13708 Captain Marbury Ln Upper Marlboro MD 20772-6118 | |
| (301) 417-5506 | |
| (301) 235-1587 |
| Full Name | Waverly Center For Psychotherapy, Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 13708 Captain Marbury Ln, Upper Marlboro, Maryland |
| Authorized Official Name and Position | Kimberly R Woodard (PRINCIPAL MEMBER) |
| Authorized Official Contact | 3014175506 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Waverly Center For Psychotherapy, Llc 13708 Captain Marbury Ln Upper Marlboro MD 20772-6118 Ph: (301) 417-5506 | Waverly Center For Psychotherapy, Llc 13708 Captain Marbury Ln Upper Marlboro MD 20772-6118 Ph: (301) 417-5506 |
| NPI Number | 1700473659 |
|---|---|
| Provider Enumeration Date | 12/27/2020 |
| Last Update Date | 12/27/2020 |
| Certification Date | 12/27/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700473659 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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