Healthcare Provider Details

I. General information

NPI: 1861323446
Provider Name (Legal Business Name): CENTER FOR PSYCHOLOGICAL CHANGE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2026
Last Update Date: 05/25/2026
Certification Date: 05/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11715 STONINGTON PL
SILVER SPRING MD
20902-1639
US

IV. Provider business mailing address

11715 STONINGTON PL
SILVER SPRING MD
20902-1639
US

V. Phone/Fax

Practice location:
  • Phone: 551-427-7887
  • Fax:
Mailing address:
  • Phone: 551-427-7887
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. JOSEPH DAVID FRIEDMAN
Title or Position: OWNER AND CLINICAL PSYCHOLOGIST
Credential: PHD
Phone: 551-427-7887