Healthcare Provider Details

I. General information

NPI: 1780435636
Provider Name (Legal Business Name): BALANCED THOUGHTS THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2024
Last Update Date: 03/28/2024
Certification Date: 03/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15887 CRABBS BRANCH WAY STE B
ROCKVILLE MD
20855-2635
US

IV. Provider business mailing address

15887 CRABBS BRANCH WAY STE B
ROCKVILLE MD
20855-2635
US

V. Phone/Fax

Practice location:
  • Phone: 202-743-2184
  • Fax:
Mailing address:
  • Phone: 202-743-2184
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: SARAH PUSKAVICH
Title or Position: OWNER, PSYCHOTHERAPIST
Credential: LCPC
Phone: 202-743-2184