Healthcare Provider Details

I. General information

NPI: 1487325866
Provider Name (Legal Business Name): INTROSPECTION COUNSELING CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2021
Last Update Date: 10/06/2025
Certification Date: 10/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10770 COLUMBIA PIKE STE 300
SILVER SPRING MD
20901-4439
US

IV. Provider business mailing address

2300 PENNSYLVANIA AVE UNIT LLC
WILMINGTON DE
19806-1392
US

V. Phone/Fax

Practice location:
  • Phone: 302-213-6158
  • Fax: 855-530-2764
Mailing address:
  • Phone: 302-213-6158
  • Fax: 855-530-2764

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: DIERDRA ORETADE-BRANCH
Title or Position: OWNER
Credential: DSW, LCSW, BCD
Phone: 302-213-6158