Healthcare Provider Details

I. General information

NPI: 1861324873
Provider Name (Legal Business Name): CENTER FOR THERAPEUTIC CONCEPTS GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 MERCANTILE LN STE 198
LARGO MD
20774-5339
US

IV. Provider business mailing address

1300 MERCANTILE LN STE 198
LARGO MD
20774-5339
US

V. Phone/Fax

Practice location:
  • Phone: 240-882-1255
  • Fax: 240-882-1255
Mailing address:
  • Phone: 240-882-1255
  • Fax: 240-882-1255

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: REGINA STANLEY
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 240-882-1255