Healthcare Provider Details

I. General information

NPI: 1629717525
Provider Name (Legal Business Name): BLEIWEIS THERAPY SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/31/2022
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6010 EXECUTIVE BLVD STE 206
NORTH BETHESDA MD
20852-3822
US

IV. Provider business mailing address

6010 EXECUTIVE BLVD STE 206
NORTH BETHESDA MD
20852-3822
US

V. Phone/Fax

Practice location:
  • Phone: 301-461-4619
  • Fax:
Mailing address:
  • Phone: 301-461-4619
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name: ROSE BLEIWEIS
Title or Position: OWNER
Credential: LCSW-C
Phone: 301-461-4619