Healthcare Provider Details

I. General information

NPI: 1942181169
Provider Name (Legal Business Name): DXT THERAPEUTIC SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2025
Last Update Date: 09/12/2025
Certification Date: 09/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7610 PENNSYLVANIA AVE STE 301
FORESTVILLE MD
20747-4764
US

IV. Provider business mailing address

7610 PENNSYLVANIA AVE STE 301
FORESTVILLE MD
20747-4764
US

V. Phone/Fax

Practice location:
  • Phone: 240-838-3707
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225C00000X
TaxonomyRehabilitation Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: MICHELLE F HARE
Title or Position: CEO
Credential:
Phone: 240-676-2895