Healthcare Provider Details

I. General information

NPI: 1841156072
Provider Name (Legal Business Name): THE MARTIN COLLECTIVE LLC DBA POTTERS THERAPEUTIC AGENCY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/31/2025
Last Update Date: 12/31/2025
Certification Date: 12/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2335 MONTAUK DR
CROFTON MD
21114-3241
US

IV. Provider business mailing address

2335 MONTAUK DR
CROFTON MD
21114-3241
US

V. Phone/Fax

Practice location:
  • Phone: 862-520-8866
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. JOCELYN MARTIN
Title or Position: OWNER/CLINICIAN
Credential: LCPC
Phone: 862-520-8866