Willow Oak Therapy Center, Inc. | |
15701 Crabbs Branch Way Rockville MD 20855-2634 | |
(301) 251-8965 | |
(301) 251-0136 |
Full Name | Willow Oak Therapy Center, Inc. |
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Speciality | Clinic/Center |
Location | 15701 Crabbs Branch Way, Rockville, Maryland |
Authorized Official Name and Position | Jody Tabner Thayer (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 3012518965 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Willow Oak Therapy Center, Inc. 15701 Crabbs Branch Way Rockville MD 20855-2634 Ph: (301) 251-8965 | Willow Oak Therapy Center, Inc. 15701 Crabbs Branch Way Rockville MD 20855-2634 Ph: (301) 251-8965 |
NPI Number | 1386620581 |
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Provider Enumeration Date | 12/20/2005 |
Last Update Date | 03/31/2017 |
Medicare PECOS PAC ID | 5698661023 |
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Medicare Enrollment ID | O20040224000411 |
Identifier | Type | State | Issuer |
---|---|---|---|
1386620581 | NPI | - | NPPES |
125603300 | Medicaid | MD | |
7726 | Other | DC | BLUE CROSS BLUE SHIELD |
5458AF | Other | MD | BCBS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
Provider Name | Suzan M Sigmond |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1861583825 PECOS PAC ID: 7517060692 Enrollment ID: I20070309000319 |
Provider Name | Carolyn E Levy |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1396950200 PECOS PAC ID: 9638118235 Enrollment ID: I20100316000049 |
Provider Name | Janet P Akman |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1477847002 PECOS PAC ID: 4981872546 Enrollment ID: I20110726000454 |
Provider Name | Emma Ridgway |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1205133436 PECOS PAC ID: 1153592985 Enrollment ID: I20120120000111 |
Provider Name | Francine Berger |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1457337396 PECOS PAC ID: 4486814761 Enrollment ID: I20120323000140 |
Provider Name | Lisa Resnick |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1306177803 PECOS PAC ID: 3173785219 Enrollment ID: I20120507000288 |
Provider Name | Jody Tabner Thayer |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1174872964 PECOS PAC ID: 5991957474 Enrollment ID: I20121207000331 |
Provider Name | Katherine Clausen |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1093802613 PECOS PAC ID: 9436202215 Enrollment ID: I20140218001470 |
Provider Name | James E Skinner |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1992103816 PECOS PAC ID: 2769794957 Enrollment ID: I20150630002655 |
Provider Name | Sharon Fisher |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1457730251 PECOS PAC ID: 4981918711 Enrollment ID: I20150806011012 |
Provider Name | Katherine S Routenberg |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1417355520 PECOS PAC ID: 0042525412 Enrollment ID: I20150813010766 |
Provider Name | Ellen C Ottenstein |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1760847693 PECOS PAC ID: 7810287034 Enrollment ID: I20160531002270 |
Provider Name | Kavita Thangavelu |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1871070169 PECOS PAC ID: 5395097018 Enrollment ID: I20181008003269 |
Provider Name | Anne-marie C Corrado |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1669705109 PECOS PAC ID: 0840586939 Enrollment ID: I20200227001004 |
Provider Name | Kristen G. Keteltas |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1821246893 PECOS PAC ID: 2961814223 Enrollment ID: I20201210002582 |
Provider Name | Mamata Hotha |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1053798470 PECOS PAC ID: 4688077670 Enrollment ID: I20210728002883 |
Provider Name | Jennifer Mittler Cohen |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1023154770 PECOS PAC ID: 0648669028 Enrollment ID: I20211105002675 |
Provider Name | Stephanie Johnston |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1194171983 PECOS PAC ID: 0749663557 Enrollment ID: I20220811001126 |
Provider Name | Sara B Solomon |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1205435724 PECOS PAC ID: 7719340033 Enrollment ID: I20230901002509 |
Provider Name | Elinor D Metz |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1922088574 PECOS PAC ID: 9931550985 Enrollment ID: I20240104000439 |
Provider Name | Sandra Shapiro |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1598422271 PECOS PAC ID: 0648614370 Enrollment ID: I20240221000856 |
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