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General NPI Number Information
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NPI Number | 1134866064
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Entity Type | Organization
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Legal Business Name | JTC BEHAVIORAL HEALTH SERVICES
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Dates
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Enumeration Date | 05/12/2022
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Last Update Date | 07/07/2025
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Provider Practice Location Address
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Address Line | 8700 CENTRAL AVE STE 300
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City | LANDOVER
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State | MD
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Zip | 20785-4853
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Country | US
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Telephone | 301-456-8766
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Fax | 240-619-4916
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Provider Business Mailing Address
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Address Line | 8700 CENTRAL AVE STE 300
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City | LANDOVER
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State | MD
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Zip | 20785-4853
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Country | US
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Telephone | 443-857-9193
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | JOHN IHUEZE IHEOMA
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Credential |
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Telephone | 443-857-9193
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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