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General NPI Number Information
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NPI Number | 1124871900
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Entity Type | Individual
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Provider Name | ELISE M RESNICK LCMFT, PHD
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Gender | Female
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Dates
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Enumeration Date | 04/10/2024
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Last Update Date | 04/10/2024
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Provider Practice Location Address
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Address Line | 11135 NEWPORT MILL RD
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City | KENSINGTON
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State | MD
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Zip | 20895-1648
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Country | US
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Telephone | 240-433-7081
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Fax |
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Provider Business Mailing Address
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Address Line | 8922 COURTS WAY
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City | SILVER SPRING
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State | MD
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Zip | 20910-2276
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Country | US
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Telephone | 240-433-7081
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | LC1000
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License Number State | MD
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