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General NPI Number Information
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NPI Number | 1376412411
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Entity Type | Organization
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Legal Business Name | THERAPEUTIC BEHAVIORAL DYNAMICS LLC
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Dates
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Enumeration Date | 11/04/2025
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Last Update Date | 11/13/2025
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Provider Practice Location Address
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Address Line | 3261 OLD WASHINGTON RD STE 2031
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City | WALDORF
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State | MD
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Zip | 20602-3313
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Country | US
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Telephone | 301-615-4150
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Fax |
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Provider Business Mailing Address
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Address Line | 3261 OLD WASHINGTON RD STE 2031
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City | WALDORF
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State | MD
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Zip | 20602-3313
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | TIFFANY YOUNGER BANKS
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Credential |
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Telephone | 301-615-4150
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 #2
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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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 | 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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Taxonomy #4
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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 #5
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #6
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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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