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General NPI Number Information
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NPI Number | 1912831926
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Entity Type | Organization
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Legal Business Name | SIDE QUEST PSYCHOTHERAPY, LLC
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Dates
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Enumeration Date | 06/12/2026
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Last Update Date | 06/12/2026
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Provider Practice Location Address
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Address Line | 7307 BALTIMORE AVE STE 109
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City | COLLEGE PARK
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State | MD
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Zip | 20740-3231
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Country | US
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Telephone | 443-741-1598
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Fax |
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Provider Business Mailing Address
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Address Line | 7307 BALTIMORE AVE STE 109
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City | COLLEGE PARK
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State | MD
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Zip | 20740-3231
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Country | US
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Telephone | 240-854-7887
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Fax |
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | JENNA STONE
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Credential | LCSW-C
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Telephone | 240-854-7887
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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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