MEDICARE: OCD DC LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	261QM0850X	Adult Mental Health Clinic/Center
2	261QM0855X	Adolescent and Children Mental Health Clinic/Center
3	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1730885104
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OCD DC LLC

Provider Business Mailing Address
First Line	:	1104 CARNATION DR
Second Line	:
City	:	ROCKVILLE
State	:	MD
Zip	:	20850-2043
Country	:	US
Telephone Number	:	240-401-3853
Fax Number	:

Provider Business Practice Location Address
First Line	:	1104 CARNATION DR
Second Line	:
City	:	ROCKVILLE
State	:	MD
Zip	:	20850-2043
Country	:	US
Telephone Number	:	240-401-3853
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	HANNAH MICHELE BRECKENRIDGE
Credential	:	LCSW-C, LCSW, LICSW
Telephone Number	:	240-618-3581

Provider Enumeration Date	:	02/06/2023
Last Update Date	:	02/06/2023

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