Healthcare Provider Details

I. General information

NPI: 1356759708
Provider Name (Legal Business Name): THERAPY ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2014
Last Update Date: 10/14/2024
Certification Date: 10/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5625 ALLENTOWN RD STE 200
SUITLAND MD
20746-4521
US

IV. Provider business mailing address

1200 STRAUSBERG ST
ACCOKEEK MD
20607
US

V. Phone/Fax

Practice location:
  • Phone: 301-241-0285
  • Fax: 866-588-4662
Mailing address:
  • Phone: 301-520-9376
  • Fax: 866-588-4662

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P0010X
TaxonomyPediatric Rehabilitation Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberW14819064
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberW14819064
License Number StateMD
# 4
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberW14819064
License Number StateMD

VIII. Authorized Official

Name: MR. WINFIELD WHITE
Title or Position: PRESIDENT/ OWNER
Credential: OTR/L
Phone: 301-241-0285