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General NPI Number Information
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NPI Number | 1861906364
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Entity Type | Organization
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Legal Business Name | THE THERAPY CONNECTION, LLC
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Dates
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Enumeration Date | 11/21/2017
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Last Update Date | 11/21/2017
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Provider Practice Location Address
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Address Line | 10610 RHODE ISLAND AVE STE 204
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City | BELTSVILLE
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State | MD
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Zip | 20705-2500
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Country | US
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Telephone | 301-358-1128
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Fax | 301-476-4199
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Provider Business Mailing Address
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Address Line | 10610 RHODE ISLAND AVE STE 204
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City | BELTSVILLE
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State | MD
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Zip | 20705-2500
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Country | US
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Telephone | 301-358-1128
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Fax | 301-476-4199
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Authorized Official
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Title or Position | COO
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Name | LESLEY-ANN BOVELL
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Credential | M.ED. CCC-SLP
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Telephone | 301-358-1128
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 17295
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | LBA248
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License Number State | MD
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