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General NPI Number Information
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NPI Number | 1871356857
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Entity Type | Organization
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Legal Business Name | TALK THERAPY POTOMAC LLC
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Dates
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Enumeration Date | 02/02/2024
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Last Update Date | 02/02/2024
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Provider Practice Location Address
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Address Line | 8800 HARNESS TRL
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City | POTOMAC
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State | MD
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Zip | 20854-2555
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Country | US
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Telephone | 224-628-3108
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Fax |
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Provider Business Mailing Address
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Address Line | 1201 SEVEN LOCKS RD STE 360
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City | ROCKVILLE
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State | MD
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Zip | 20854-6901
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Country | US
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Telephone | 224-628-3108
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Fax |
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Authorized Official
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Title or Position | PSYCHOTHERAPIST
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Name | MELISSA SUSSER
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Credential | LICSW
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Telephone | 224-628-3108
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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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