Healthcare Provider Details

I. General information

NPI: 1730692278
Provider Name (Legal Business Name): THE INSTITUTE FOR EMOTIONAL REGULATION, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2017
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 POST OFFICE RD
WALDORF MD
20602-2738
US

IV. Provider business mailing address

16140 GINGER ROOT LN
BRANDYWINE MD
20613-4186
US

V. Phone/Fax

Practice location:
  • Phone: 202-297-9992
  • Fax: 800-956-3010
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: GREGORY INGRAM
Title or Position: C.E.O.
Credential: LCSW-C
Phone: 202-297-9992