Healthcare Provider Details

I. General information

NPI: 1861036436
Provider Name (Legal Business Name): THE PSYCHOTHERAPY AND BEHAVIORAL HEALTH NETWORK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2019
Last Update Date: 03/04/2025
Certification Date: 05/31/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44679 ENDICOTT DR STE 300 #431
ASHBURN VA
20147
US

IV. Provider business mailing address

325 ELLINGTON BOULEVARD PMB 509
GAITHERSBURG MD
20878
US

V. Phone/Fax

Practice location:
  • Phone: 240-428-0465
  • Fax: 240-846-3721
Mailing address:
  • Phone: 240-428-0465
  • Fax: 240-846-3721

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. BARBARA S ADIKA
Title or Position: PSYCHOTHERAPIST/OWNER
Credential: LCPC
Phone: 240-428-0465