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General NPI Number Information
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NPI Number | 1982490454
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Entity Type | Organization
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Legal Business Name | MARYLAND CENTER FOR EVIDENCE BASED THERAPY LLC
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Dates
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Enumeration Date | 04/19/2025
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Last Update Date | 04/19/2025
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Provider Practice Location Address
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Address Line | 5530 WISCONSIN AVE STE 965
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City | CHEVY CHASE
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State | MD
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Zip | 20815-4325
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Country | US
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Telephone | 913-912-3545
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Fax |
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Provider Business Mailing Address
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Address Line | 14317 SHOREHAM DR
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City | SILVER SPRING
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State | MD
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Zip | 20905-4481
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Country | US
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Telephone | 913-912-3545
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Fax |
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | DR. JOHN P. DENNIS
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Credential | PHD
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Telephone | 913-912-3545
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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