Healthcare Provider Details

I. General information

NPI: 1356160089
Provider Name (Legal Business Name): PEACE X PROGRESS THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2024
Last Update Date: 03/27/2026
Certification Date: 03/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8403 COLESVILLE RD STE 1100
SILVER SPRING MD
20910-6346
US

IV. Provider business mailing address

8403 COLESVILLE RD STE 1100
SILVER SPRING MD
20910-6346
US

V. Phone/Fax

Practice location:
  • Phone: 240-334-7444
  • Fax:
Mailing address:
  • Phone: 240-334-7444
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: ONGISA ICHILE-MCKENZIE
Title or Position: ADMINISTRATOR
Credential:
Phone: 240-334-7444