=====================================================
General NPI Number Information
=====================================================
NPI Number | 1720818891
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PRIORITIZE PEACE THERAPEUTIC SERVICES
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/05/2024
-----------------------------------------------------
Last Update Date | 08/05/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9658 MARLBORO PIKE
-----------------------------------------------------
City | UPPER MARLBORO
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20772-3767
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 301-848-9447
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3515 REGENCY PKWY
-----------------------------------------------------
City | DISTRICT HEIGHTS
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20747-3819
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 301-848-9447
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | FOUNDER/ CEO
-----------------------------------------------------
Name | MS. CHAUNTIA POSTELL BRIDGES
-----------------------------------------------------
Credential | LICSW
-----------------------------------------------------
Telephone | 301-848-9447
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 104100000X
-----------------------------------------------------
Taxonomy Name | Social Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------