MEDICARE: HOLDING SPACE SERVICES

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	103TC0700X	Clinical Psychologist
2	1041C0700X	Clinical Social Worker
3	363LP0808X	Psychiatric/Mental Health Nurse Practitioner
4	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1679428478
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOLDING SPACE SERVICES

Provider Business Mailing Address
First Line	:	3037 LEMONADE LN
Second Line	:
City	:	UPPER MARLBORO
State	:	MD
Zip	:	20774-2736
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3037 LEMONADE LN
Second Line	:
City	:	UPPER MARLBORO
State	:	MD
Zip	:	20774-2736
Country	:	US
Telephone Number	:	202-247-0279
Fax Number	:

Authorized Official
Title or Position	:	CO-OWNER
Name	:	SHANTAE J ELLIOTT
Credential	:	LCPC
Telephone Number	:	202-247-0279

Provider Enumeration Date	:	02/27/2026
Last Update Date	:	02/27/2026

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Directions to “HOLDING SPACE SERVICES ” Practice Location

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