Healthcare Provider Details

I. General information

NPI: 1295525244
Provider Name (Legal Business Name): TAKOMA-LANGLEY PARK BEHAVIORAL HEALTH SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2025
Last Update Date: 05/12/2025
Certification Date: 05/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7517 NEW HAMPSHIRE AVE
TAKOMA PARK MD
20912-6969
US

IV. Provider business mailing address

7517 NEW HAMPSHIRE AVE
TAKOMA PARK MD
20912-6969
US

V. Phone/Fax

Practice location:
  • Phone: 240-450-2092
  • Fax:
Mailing address:
  • Phone: 240-450-2092
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DUNSTANA SOGIE-THOMAS
Title or Position: DIRECTOR
Credential:
Phone: 301-850-8999