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
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1306437876
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	:	240-360-2161
Fax Number	:	240-298-1698

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	:	240-360-2161
Fax Number	:	240-298-1698

Authorized Official
Title or Position	:	CEO/EXECUTIVE DIRECTOR
Name	:	TIERRA ELLIS
Credential	:
Telephone Number	:	240-360-2161

Provider Enumeration Date	:	01/28/2021
Last Update Date	:	06/05/2023

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Directions to “NEXTGENERATION THERAPEUTIC SERVICES ” Practice Location

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