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NPI Code Detail

MEDICARE: NEXTGENERATION THERAPEUTIC SERVICES

MEDICARE: NEXTGENERATION THERAPEUTIC SERVICES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1275298861
Entity Type Code : Organization
Provider Name (Legal Business Name) : NEXTGENERATION THERAPEUTIC SERVICES
Provider Business Mailing Address
First Line : 14900 SWEITZER LN STE 200
Second Line :
City : LAUREL
State : MD
Zip : 20707-2915
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 14900 SWEITZER LN STE 200
Second Line :
City : LAUREL
State : MD
Zip : 20707-2915
Country : US
Telephone Number : 443-561-6102
Fax Number :
Authorized Official
Title or Position : CEO/EXECUTIVE DIRECTOR
Name : TIERRA ELLIS
Credential :
Telephone Number : 240-360-2161
Provider Enumeration Date : 11/08/2021
Last Update Date : 06/05/2023

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1447781752 — NEXTGENERATION THERAPEUTIC SERVICES
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1306437876 — NEXTGENERATION THERAPEUTIC SERVICES
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1487348314 — TIERRA ELLIS
Practice Location Address:
14900 SWEITZER LN STE 200
LAUREL, MD
20707-2915
Practice Phone: 240-360-2161
Practice Fax: 240-360-1938

Directions to “NEXTGENERATION THERAPEUTIC SERVICES ” Practice Location

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