Healthcare Provider Details

I. General information

NPI: 1487463162
Provider Name (Legal Business Name): CONNECTING THE PIECES ; MENTAL HEALTH SOLUTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2025
Last Update Date: 01/06/2025
Certification Date: 01/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2670 CRAIN HWY STE 510
WALDORF MD
20601-2819
US

IV. Provider business mailing address

2670 CRAIN HWY STE 510
WALDORF MD
20601-2819
US

V. Phone/Fax

Practice location:
  • Phone: 301-778-1335
  • Fax:
Mailing address:
  • Phone: 301-778-1335
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: DEBORAH BERNETTA ALLEN
Title or Position: CLINICAL DIRECTOR
Credential: LCPC-S
Phone: 240-416-6836