Healthcare Provider Details

I. General information

NPI: 1013521616
Provider Name (Legal Business Name): CHRISLIN THERAPUTIC SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2020
Last Update Date: 06/18/2025
Certification Date: 06/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8355 GROVENOR CT
WHITE PLAINS MD
20695-3476
US

IV. Provider business mailing address

8355 GROVENOR CT
WHITE PLAINS MD
20695-3476
US

V. Phone/Fax

Practice location:
  • Phone: 202-810-1942
  • Fax:
Mailing address:
  • Phone: 202-810-1942
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MRS. YANTISE JENKINS
Title or Position: CLINICAL DIRECTOR
Credential: LICSW, LCSW-C,S
Phone: 202-810-1942