Healthcare Provider Details

I. General information

NPI: 1538093372
Provider Name (Legal Business Name): PROFESSIONAL PSYCHOTHERAPY CONSULTING CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

124 DUVALL LN APT 201
GAITHERSBURG MD
20877-1645
US

IV. Provider business mailing address

124 DUVALL LN APT 201
GAITHERSBURG MD
20877-1645
US

V. Phone/Fax

Practice location:
  • Phone: 240-672-8289
  • Fax:
Mailing address:
  • Phone: 240-672-8289
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: MR. JULIO EXEQUIEL OROZCO
Title or Position: MANAGER
Credential:
Phone: 240-306-4947