Healthcare Provider Details
I. General information
NPI: 1780828061
Provider Name (Legal Business Name): TERESA D COMBS PHD, APRN, BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/30/2009
Last Update Date: 09/03/2024
Certification Date: 09/03/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8777 1ST AVE # A
SILVER SPRING MD
20910
US
IV. Provider business mailing address
8777 1ST AVE # A
SILVER SPRING MD
20910-3511
US
V. Phone/Fax
- Phone: 301-920-0316
- Fax: 301-565-9621
- Phone: 301-920-0316
- Fax: 301-565-9621
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YS0200X |
| Taxonomy | School Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | RN61601 |
| License Number State | DC |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | R121391 |
| License Number State | MD |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
| # 1 | |
| Identifier | 099052800 |
| Identifier Type | MEDICAID |
| Identifier State | DC |
| Identifier Issuer | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: