Healthcare Provider Details

I. General information

NPI: 1558858217
Provider Name (Legal Business Name): TREE HOUSE CHILD ADVOCACY CENTER OF MONTGOMERY COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2018
Last Update Date: 11/22/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7300 CALHOUN PL STE 700
ROCKVILLE MD
20855-3702
US

IV. Provider business mailing address

7300 CALHOUN PL SUITE 500
ROCKVILLE MD
20855-3702
US

V. Phone/Fax

Practice location:
  • Phone: 240-777-4699
  • Fax:
Mailing address:
  • Phone: 240-777-4699
  • Fax: 240-777-4470

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code2080C0008X
TaxonomyChild Abuse Pediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. CHARLES D. REGAN JR.
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 240-777-4777