Healthcare Provider Details

I. General information

NPI: 1134784648
Provider Name (Legal Business Name): ASSURANCE QUALITY CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2019
Last Update Date: 02/20/2023
Certification Date: 02/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9440 MARLBORO PIKE # 330
UPPER MARLBORO MD
20772-3659
US

IV. Provider business mailing address

9440 PENNSYLVANIA AVE STE 330
UPPER MARLBORO MD
20772-3659
US

V. Phone/Fax

Practice location:
  • Phone: 301-899-2210
  • Fax: 888-205-3238
Mailing address:
  • Phone: 301-899-2210
  • Fax: 800-465-8147

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 4
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: MS. EVELYN MAYE
Title or Position: CEO
Credential: LPC, CRC, CAC-I, CNA
Phone: 202-210-5891