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General NPI Number Information
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NPI Number | 1174183081
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Entity Type | Organization
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Legal Business Name | THERAPEUTIC GREENHOUSE, LLC.
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Dates
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Enumeration Date | 06/13/2019
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Last Update Date | 08/18/2022
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Provider Practice Location Address
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Address Line | 120 SISTER PIERRE DR STE 506
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City | BALTIMORE
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State | MD
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Zip | 21204-7527
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Country | US
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Telephone | 410-670-4769
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Fax | 410-847-2545
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Provider Business Mailing Address
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Address Line | 722 DULANEY VALLEY RD STE 366
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City | TOWSON
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State | MD
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Zip | 21204-5109
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Country | US
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Telephone | 410-670-4769
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Fax | 410-847-2545
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Authorized Official
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Title or Position | OWNER/CEO
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Name | DEANA DENISE JOHNSON
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Credential | LCSW-C
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Telephone | 443-983-6641
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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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 | 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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