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General NPI Number Information
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NPI Number | 1992643902
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Entity Type | Organization
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Legal Business Name | THERAPY SPACE
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Dates
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Enumeration Date | 03/23/2026
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Last Update Date | 03/23/2026
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Provider Practice Location Address
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Address Line | 6 DARBYTOWN CT
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City | NOTTINGHAM
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State | MD
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Zip | 21236-4786
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Country | US
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Telephone | 410-294-6702
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Fax |
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Provider Business Mailing Address
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Address Line | 6 DARBYTOWN CT
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City | NOTTINGHAM
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State | MD
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Zip | 21236-4786
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Country | US
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Telephone | 410-294-6702
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | KATIE DAVELLA
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Credential | LCPC
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Telephone | 410-294-6702
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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 |
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License Number State |
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