MEDICARE: BUILDING BEYOND THERAPY LLC

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	1041C0700X	Clinical Social Worker	17977	MD

General Provider Information

NPI Number	:	1699278424
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BUILDING BEYOND THERAPY LLC

Provider Business Mailing Address
First Line	:	1300 MERCANTILE LN STE 134C
Second Line	:
City	:	UPPER MARLBORO
State	:	MD
Zip	:	20774-5332
Country	:	US
Telephone Number	:	240-681-9721
Fax Number	:

Provider Business Practice Location Address
First Line	:	1300 MERCANTILE LN STE 134C
Second Line	:
City	:	UPPER MARLBORO
State	:	MD
Zip	:	20774-5332
Country	:	US
Telephone Number	:	240-681-9721
Fax Number	:

Authorized Official
Title or Position	:	CLINICAL SOCIAL WORKER/OWNER
Name	:	KRISTEN BROOKS
Credential	:	LCSW-C, LICSW
Telephone Number	:	240-681-9721

Provider Enumeration Date	:	03/18/2018
Last Update Date	:	03/18/2018

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Directions to “BUILDING BEYOND THERAPY LLC ” Practice Location

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