Healthcare Provider Details

I. General information

NPI: 1114261294
Provider Name (Legal Business Name): INTEGRATIVE THERAPY OF GREATER WASHINGTON, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2012
Last Update Date: 11/15/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5818 HUBBARD DR STE B
ROCKVILLE MD
20852-5817
US

IV. Provider business mailing address

5818 HUBBARD DR STE B
ROCKVILLE MD
20852-5817
US

V. Phone/Fax

Practice location:
  • Phone: 301-468-4849
  • Fax:
Mailing address:
  • Phone: 301-468-4849
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. JULIE BINDEMAN
Title or Position: CO-DIRECTOR
Credential: PSY-D
Phone: 301-801-6775